Healthcare Provider Details

I. General information

NPI: 1770541443
Provider Name (Legal Business Name): GEORGINA D KRIZSA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W VALENCIA PALOMA MEDICAL GROUP
TUCSON AZ
85746
US

IV. Provider business mailing address

655 N ALVERNON ARIZONA COMMUNITY PHYSICIANS PC SUITE 216
TUCSON AZ
85711
US

V. Phone/Fax

Practice location:
  • Phone: 520-751-3312
  • Fax: 520-547-5785
Mailing address:
  • Phone: 520-547-4902
  • Fax: 520-795-0225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20894
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: