Basic Information
| Provider Information | |||||||||
| NPI: | 1760683494 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY PHYSICIANS HEALTHCARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 919 N STONE AVE | ||||||||
| Address2: | APT 3411 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857057932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5204614726 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2800 E AJO WAY | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857136204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206941460 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2007 | ||||||||
| LastUpdateDate: | 11/05/2007 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROF., CHAIRMAN | ||||||||
| AuthorizedOfficialTelephone: | 5206941460 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 284300000X | PG PERMIT #78117 | AZ | Y | Hospitals | Special Hospital |
No ID Information.