MEDICARE: DESERT SKY SPINE & SPORTS MEDICINE PC

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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	005226	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316258361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT SKY SPINE & SPORTS MEDICINE PC

Provider Business Mailing Address
First Line	:	6585 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-5614
Country	:	US
Telephone Number	:	520-229-2080
Fax Number	:	520-229-2092

Provider Business Practice Location Address
First Line	:	6585 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-5614
Country	:	US
Telephone Number	:	520-229-2080
Fax Number	:	520-229-2092

Authorized Official
Title or Position	:	PRESIDENT/ OWNER/ CEO
Name	:	DR. THOMAS ANTHONY COURY II
Credential	:	D.O.
Telephone Number	:	520-229-2080

Provider Enumeration Date	:	06/24/2010
Last Update Date	:	12/29/2023

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