Healthcare Provider Details

I. General information

NPI: 1083545289
Provider Name (Legal Business Name): JOEY GHOTMI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 S 6TH AVE
TUCSON AZ
85723-0001
US

IV. Provider business mailing address

3601 S 6TH AVE
TUCSON AZ
85723-0001
US

V. Phone/Fax

Practice location:
  • Phone: 520-792-1450
  • Fax: 520-629-4631
Mailing address:
  • Phone: 520-792-1450
  • Fax: 520-629-4631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR82687
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: