Healthcare Provider Details

I. General information

NPI: 1659373892
Provider Name (Legal Business Name): HENRY THOMAS SETHNEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 09/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 W. ORANGE GROVE RD.
TUCSON AZ
85741
US

IV. Provider business mailing address

6325 E. TANQUE VERDE RD.
TUCSON AZ
85715
US

V. Phone/Fax

Practice location:
  • Phone: 520-742-9777
  • Fax: 520-885-7396
Mailing address:
  • Phone: 520-795-5830
  • Fax: 520-885-7396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number7744
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number7744
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: