MEDICARE: TUCSON DIGESTIVE INSTITUTE LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1932636123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TUCSON DIGESTIVE INSTITUTE LLC

Provider Business Mailing Address
First Line	:	7566 N LA CHOLLA BLVD
Second Line	:	STE B
City	:	TUCSON
State	:	AZ
Zip	:	85741-6491
Country	:	US
Telephone Number	:	520-547-5847
Fax Number	:

Provider Business Practice Location Address
First Line	:	7566 N LA CHOLLA BLVD STE B
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741
Country	:	US
Telephone Number	:	520-742-4139
Fax Number	:	520-742-0814

Authorized Official
Title or Position	:	OFFICER/AUTHORIZED OFFICIAL
Name	:	ERIC BOON
Credential	:
Telephone Number	:	480-567-0269

Provider Enumeration Date	:	05/18/2017
Last Update Date	:	05/08/2026

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