Healthcare Provider Details

I. General information

NPI: 1497805733
Provider Name (Legal Business Name): AMERIPATH TUCSON INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 N ALVERNON WAY
TUCSON AZ
85711-1843
US

IV. Provider business mailing address

14275 MIDWAY RD STE 400
ADDISON TX
75001-3614
US

V. Phone/Fax

Practice location:
  • Phone: 520-320-7681
  • Fax:
Mailing address:
  • Phone:
  • Fax: 610-271-4245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number03D0980494
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number03D0980494
License Number StateAZ

VIII. Authorized Official

Name: DARREN THOMAS WHEELER
Title or Position: VICE PRESIDENT
Credential:
Phone: 702-733-7866