Healthcare Provider Details

I. General information

NPI: 1972588960
Provider Name (Legal Business Name): VICTORIA R. FEWELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6261 N LA CHOLLA BLVD STE 277
TUCSON AZ
85741-3564
US

IV. Provider business mailing address

2424 N WYATT DR STE 260
TUCSON AZ
85712-6118
US

V. Phone/Fax

Practice location:
  • Phone: 520-877-3800
  • Fax: 520-877-3801
Mailing address:
  • Phone: 520-795-0608
  • Fax: 520-795-0354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25556
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: