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General NPI Number Information
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NPI Number | 1013517333
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Entity Type | Organization
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Legal Business Name | AMG MEDICAL TUCSON LLC
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 6130 N LA CHOLLA BLVD STE 117
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City | TUCSON
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State | AZ
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Zip | 85741-3589
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Country | US
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Telephone | 520-207-7434
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Fax | 520-269-6897
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Provider Business Mailing Address
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Address Line | 6130 N LA CHOLLA BLVD STE 117
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City | TUCSON
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State | AZ
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Zip | 85741-3589
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Country | US
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Telephone | 520-207-7434
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Fax | 520-269-6897
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Authorized Official
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Title or Position | MD / OWNER
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Name | AMANDA BACCHUS-MORRIS
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Credential | MD
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Telephone | 520-207-7434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RB0002X
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Taxonomy Name | Obesity Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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