Healthcare Provider Details

I. General information

NPI: 1316258361
Provider Name (Legal Business Name): DESERT SKY SPINE & SPORTS MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6585 N ORACLE RD
TUCSON AZ
85704-5614
US

IV. Provider business mailing address

6585 N ORACLE RD
TUCSON AZ
85704-5614
US

V. Phone/Fax

Practice location:
  • Phone: 520-229-2080
  • Fax: 520-229-2092
Mailing address:
  • Phone: 520-229-2080
  • Fax: 520-229-2092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number005226
License Number StateAZ

VIII. Authorized Official

Name: DR. THOMAS ANTHONY COURY II
Title or Position: PRESIDENT/ OWNER/ CEO
Credential: D.O.
Phone: 520-229-2080