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General NPI Number Information
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NPI Number | 1124326558
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Entity Type | Organization
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Legal Business Name | WEST AJO MEDICAL CENTER LTD.
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 101 W AJO WAY
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City | TUCSON
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State | AZ
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Zip | 85713-6036
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Country | US
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Telephone | 520-573-0993
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Fax | 520-573-0440
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Provider Business Mailing Address
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Address Line | 101 W AJO WAY
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City | TUCSON
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State | AZ
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Zip | 85713-6036
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Country | US
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Telephone | 520-573-0993
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Fax | 520-573-0440
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Authorized Official
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Title or Position | OWNER/SOLE PROPRIETOR
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Name | DR. ALBERT ROBERT FRITZ III
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Credential | D.O.
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Telephone | 520-573-0993
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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 | 1951
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License Number State | AZ
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