Healthcare Provider Details

I. General information

NPI: 1134283500
Provider Name (Legal Business Name): SUSAN B. FLEMING, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4725 N 1ST AVE
TUCSON AZ
85718-5610
US

IV. Provider business mailing address

4725 N 1ST AVE
TUCSON AZ
85718-5610
US

V. Phone/Fax

Practice location:
  • Phone: 520-888-2424
  • Fax: 520-888-8493
Mailing address:
  • Phone: 520-888-2424
  • Fax: 520-888-8493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SUSAN B FLEMING
Title or Position: PRESIDENT
Credential: M.D.
Phone: 520-888-2427