Healthcare Provider Details

I. General information

NPI: 1750350401
Provider Name (Legal Business Name): SILVIO ANTONIO ARISTIZABAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 06/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 W SAINT MARYS RD
TUCSON AZ
85745-2624
US

IV. Provider business mailing address

1760 E RIVER RD 350
TUCSON AZ
85718-5999
US

V. Phone/Fax

Practice location:
  • Phone: 520-791-7996
  • Fax: 520-791-3329
Mailing address:
  • Phone: 520-519-7775
  • Fax: 520-519-7760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number8043
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: