MEDICARE: DR. JONATHAN R INSEL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	12369	AZ
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	12369	AZ

General Provider Information

NPI Number	:	1053350728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN R INSEL MD

Provider Business Mailing Address
First Line	:	5055 E BROADWAY BLVD STE A-100
Second Line	:	ARIZONA COMMUNITY PHYSICIANS
City	:	TUCSON
State	:	AZ
Zip	:	85711-3629
Country	:	US
Telephone Number	:	520-327-0460
Fax Number	:	520-795-0225

Provider Business Practice Location Address
First Line	:	6369 E TANQUE VERDE RD
Second Line	:	SUITE 150
City	:	TUCSON
State	:	AZ
Zip	:	85715-3850
Country	:	US
Telephone Number	:	520-886-5534
Fax Number	:	520-886-5577

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	05/08/2009

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