Healthcare Provider Details

I. General information

NPI: 1518969773
Provider Name (Legal Business Name): ARIZONA SKIN CANCER SURGERY CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5980 N LA CHOLLA BLVD
TUCSON AZ
85741-3535
US

IV. Provider business mailing address

PO BOX 37075
TUCSON AZ
85740-7075
US

V. Phone/Fax

Practice location:
  • Phone: 520-887-3333
  • Fax: 520-887-3344
Mailing address:
  • Phone: 520-887-3333
  • Fax: 520-887-3344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberOSC-3599
License Number StateAZ

VIII. Authorized Official

Name: MICHAEL J. HUETHER
Title or Position: PRESIDENT/PHYSICIAN
Credential: M.D.
Phone: 520-887-3333