Healthcare Provider Details

I. General information

NPI: 1558312991
Provider Name (Legal Business Name): SARAH J ENZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 04/26/2021
Certification Date: 04/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1595 E RIVER RD STE 201
TUCSON AZ
85718-5984
US

IV. Provider business mailing address

1595 E RIVER RD STE 201
TUCSON AZ
85718-5984
US

V. Phone/Fax

Practice location:
  • Phone: 520-293-5757
  • Fax: 520-293-7358
Mailing address:
  • Phone: 520-293-5757
  • Fax: 520-293-7358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number40117-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: