Healthcare Provider Details

I. General information

NPI: 1902847031
Provider Name (Legal Business Name): ELLEN MARIE PAIGE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 W FRANKLIN ST
TUCSON AZ
85701-8207
US

IV. Provider business mailing address

329 W FRANKLIN ST
TUCSON AZ
85701-8207
US

V. Phone/Fax

Practice location:
  • Phone: 520-884-5249
  • Fax: 520-547-3395
Mailing address:
  • Phone: 520-884-5249
  • Fax: 520-547-3395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number18995
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number18995
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: