Healthcare Provider Details

I. General information

NPI: 1366798159
Provider Name (Legal Business Name): RAO PLASTIC SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2012
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7341 E TANQUE VERDE RD
TUCSON AZ
85715-3475
US

IV. Provider business mailing address

7341 E TANQUE VERDE RD
TUCSON AZ
85715-3475
US

V. Phone/Fax

Practice location:
  • Phone: 520-209-2500
  • Fax: 520-545-7250
Mailing address:
  • Phone: 520-209-2500
  • Fax: 520-545-7250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number45834
License Number StateAZ

VIII. Authorized Official

Name: ARUN JAY RAO
Title or Position: OWNER
Credential: MD
Phone: 520-209-2500