Healthcare Provider Details

I. General information

NPI: 1457285397
Provider Name (Legal Business Name): DESIREE MONIQUE JUSTUS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 S COUNTRY CLUB RD STE 130
TUCSON AZ
85714-2203
US

IV. Provider business mailing address

1459 W KIRKWELL PL
TUCSON AZ
85746-3989
US

V. Phone/Fax

Practice location:
  • Phone: 520-670-3909
  • Fax: 520-309-2560
Mailing address:
  • Phone: 623-755-3134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR4947
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: