Healthcare Provider Details

I. General information

NPI: 1093959744
Provider Name (Legal Business Name): JOSEPH S MACHUZAK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2009
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 E CARONDELET DR STE 145
TUCSON AZ
85710-2180
US

IV. Provider business mailing address

6565 E CARONDELET DR STE 145
TUCSON AZ
85710-2180
US

V. Phone/Fax

Practice location:
  • Phone: 520-886-4199
  • Fax: 520-886-3114
Mailing address:
  • Phone: 520-886-4199
  • Fax: 520-886-3114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number3753
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: