Healthcare Provider Details

I. General information

NPI: 1821073446
Provider Name (Legal Business Name): DAVID E MCHORNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5983 E GRANT RD STE 117
TUCSON AZ
85712-2366
US

IV. Provider business mailing address

5055 E BROADWAY BLVD STE A100
TUCSON AZ
85711-3629
US

V. Phone/Fax

Practice location:
  • Phone: 520-721-5350
  • Fax: 520-547-5749
Mailing address:
  • Phone: 520-327-0460
  • Fax: 520-795-0225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number29937
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: