Healthcare Provider Details

I. General information

NPI: 1043276843
Provider Name (Legal Business Name): GEORGE O MAISH III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 N CAMPBELL AVE BLDG 2
TUCSON AZ
85719-1454
US

IV. Provider business mailing address

1501 N CAMPBELL AVE STE 5411
TUCSON AZ
85724-0001
US

V. Phone/Fax

Practice location:
  • Phone: 520-626-2479
  • Fax:
Mailing address:
  • Phone: 520-626-2479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number79873
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number79873
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: