Healthcare Provider Details

I. General information

NPI: 1356529820
Provider Name (Legal Business Name): TARIN MIGNON BYNUM NEAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2008
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 S CAMPBELL AVE
GREEN VALLEY AZ
85614-0504
US

IV. Provider business mailing address

1260 S CAMPBELL AVE
GREEN VALLEY AZ
85614-0504
US

V. Phone/Fax

Practice location:
  • Phone: 520-407-5600
  • Fax: 520-407-5990
Mailing address:
  • Phone: 520-407-5600
  • Fax: 520-407-5990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301090314
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number42861
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: