MEDICARE: DR. EDWARD TOGNACCI DO

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	208D00000X	General Practice Physician	5101015106	MI
2	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	5101015106	MI

General Provider Information

NPI Number	:	1265410351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD TOGNACCI DO

Provider Business Mailing Address
First Line	:	PO BOX 15070
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85267-5070
Country	:	US
Telephone Number	:	602-839-6968
Fax Number	:	602-839-4144

Provider Business Practice Location Address
First Line	:	1111 E MCDOWELL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2612
Country	:	US
Telephone Number	:	602-839-6968
Fax Number	:	602-839-4144

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

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	07/16/2024

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