Healthcare Provider Details

I. General information

NPI: 1023001567
Provider Name (Legal Business Name): ROY R. GETTEL MDPLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 W HOSPITAL DR
TUCSON AZ
85704-7802
US

IV. Provider business mailing address

1980 W HOSPITAL DR
TUCSON AZ
85704-7804
US

V. Phone/Fax

Practice location:
  • Phone: 520-742-0900
  • Fax: 520-742-1371
Mailing address:
  • Phone: 520-742-0900
  • Fax: 520-742-1371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number11015
License Number StateAZ

VIII. Authorized Official

Name: DR. ROY RICHARD GETTEL
Title or Position: SOLE PROPRIETOR
Credential: M.D. PLLC
Phone: 520-742-0900