Basic Information
| Provider Information | |||||||||
| NPI: | 1871758730 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE UNIVERSITY OF ARIZONA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1501 N CAMPBELL AVE | ||||||||
| Address2: | PO BOX 245073 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857245073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206267944 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1501 N CAMPBELL AVE | ||||||||
| Address2: | ARIZONA HEALTH SCIENCES NUMBER ROOM 3335 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857245073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206267944 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2008 | ||||||||
| LastUpdateDate: | 07/21/2008 | ||||||||
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| AuthorizedOfficialLastName: | SAMPSON | ||||||||
| AuthorizedOfficialFirstName: | STEPHANIE | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PEDIATRIC COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 5206267944 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC2000X | R70642 | AZ | Y | Hospitals | General Acute Care Hospital | Children |
No ID Information.