Healthcare Provider Details

I. General information

NPI: 1346210655
Provider Name (Legal Business Name): DAVID ANTHONY EMMERSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7158 E DESERT MOON LOOP
TUCSON AZ
85750-0918
US

IV. Provider business mailing address

7158 E DESERT MOON LOOP
TUCSON AZ
85750-0918
US

V. Phone/Fax

Practice location:
  • Phone: 520-403-0300
  • Fax:
Mailing address:
  • Phone: 520-403-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number7700
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number7700
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: