Basic Information
| Provider Information | |||||||||
| NPI: | 1972248540 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESTIPONA | ||||||||
| FirstName: | BENZI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2001 N NANCY ROSE BLVD | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857123518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802425499 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1501 N CAMPBELL AVE STE 8401 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857240001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206269245 | ||||||||
| FaxNumber: | 5206262668 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2022 | ||||||||
| LastUpdateDate: | 04/28/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | R79428 | AZ | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.