Healthcare Provider Details
I. General information
NPI: 1235250267
Provider Name (Legal Business Name): DESERT MEDICAL GROUP, LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2121 N BEVERLY AVE SUITE 105
TUCSON AZ
85712-2154
US
IV. Provider business mailing address
2121 N BEVERLY AVE SUITE 105
TUCSON AZ
85712-2154
US
V. Phone/Fax
- Phone: 520-327-6265
- Fax: 520-327-9300
- Phone: 520-327-6265
- Fax: 520-327-9300
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | 6070 |
| License Number State | AZ |
VIII. Authorized Official
Name:
J. STEVEN
STRONG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 520-327-6265