Healthcare Provider Details

I. General information

NPI: 1083669949
Provider Name (Legal Business Name): NORTHWEST RHEUMATOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W COOL DR STE 107
TUCSON AZ
85704-6551
US

IV. Provider business mailing address

403 W COOL DR STE 107
TUCSON AZ
85704-6551
US

V. Phone/Fax

Practice location:
  • Phone: 520-792-2199
  • Fax:
Mailing address:
  • Phone: 520-792-2199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number30725
License Number StateAZ

VIII. Authorized Official

Name: ULKER TOK
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 520-792-2199