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General NPI Number Information
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NPI Number | 1295100816
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Entity Type | Organization
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Legal Business Name | MARTY GILES, MD, P.C.
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Dates
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Enumeration Date | 12/08/2015
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 7395 E TANQUE VERDE RD SUITE 175
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City | TUCSON
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State | AZ
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Zip | 85715-3475
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Country | US
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Telephone | 520-547-2311
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Fax |
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Provider Business Mailing Address
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Address Line | 7395 E TANQUE VERDE RD SUITE 175
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City | TUCSON
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State | AZ
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Zip | 85715-3475
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. MARTY GILES
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Credential | MD
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Telephone | 520-547-2311
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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 | 23554
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License Number State | AZ
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