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General NPI Number Information
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NPI Number | 1104253004
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Entity Type | Organization
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Legal Business Name | CHRISTINE TYMCZYNA DO PLLC
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Dates
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Enumeration Date | 10/09/2013
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Last Update Date | 11/25/2017
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Provider Practice Location Address
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Address Line | 4450 S RURAL RD STE C230
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City | TEMPE
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State | AZ
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Zip | 85282-7020
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Country | US
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Telephone | 602-237-5088
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Fax | 602-900-9967
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Provider Business Mailing Address
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Address Line | 4450 S RURAL RD STE C230
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City | TEMPE
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State | AZ
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Zip | 85282-7020
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Country | US
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Telephone | 602-237-5088
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Fax | 602-900-9967
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTINE TYMCZYNA
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Credential | DO
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Telephone | 602-237-5088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0055207
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License Number State | AZ
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