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General NPI Number Information
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NPI Number | 1154307346
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Entity Type | Individual
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Provider Name | CONSTANCE G URIBE MD
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Gender | Female
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 2244 S AVE A #D
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City | YUMA
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State | AZ
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Zip | 85364-8341
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Country | US
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Telephone | 928-782-9274
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Fax | 928-783-7324
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Provider Business Mailing Address
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Address Line | 2244 S AVE A #D
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City | YUMA
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State | AZ
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Zip | 85364-8341
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Country | US
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Telephone | 928-782-9274
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Fax | 928-783-7324
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 11877
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A3044
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License Number State | CA
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