Healthcare Provider Details

I. General information

NPI: 1255389532
Provider Name (Legal Business Name): ROBERT L. DEAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 08/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1358 W. ORANGE GROVE
TUCSON AZ
85704
US

IV. Provider business mailing address

2121 N CRAYCROFT RD BLDG 5
TUCSON AZ
85712-2801
US

V. Phone/Fax

Practice location:
  • Phone: 520-575-1272
  • Fax: 520-575-1789
Mailing address:
  • Phone: 520-296-8500
  • Fax: 520-733-2389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number32516
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: