Healthcare Provider Details

I. General information

NPI: 1033105002
Provider Name (Legal Business Name): ANDRZEJ HONORY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 09/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E AJO WAY
TUCSON AZ
85713-6204
US

IV. Provider business mailing address

2800 E AJO WAY
TUCSON AZ
85713-6204
US

V. Phone/Fax

Practice location:
  • Phone: 520-874-7500
  • Fax:
Mailing address:
  • Phone: 520-874-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number30765
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: