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General NPI Number Information
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NPI Number | 1447251541
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Entity Type | Organization
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Legal Business Name | TUCSON MUSCULOSKELETAL LLC
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2424 N WYATT DR #160
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City | TUCSON
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State | AZ
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Zip | 85712-6115
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Country | US
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Telephone | 520-324-3922
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Fax | 520-324-3096
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Provider Business Mailing Address
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Address Line | PO BOX 13186
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City | TUCSON
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State | AZ
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Zip | 85732-3186
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Country | US
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Telephone | 520-324-3922
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Fax | 520-324-3096
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. STUART KATZ
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Credential | FACHE
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Telephone | 520-324-3917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | OSC-3143
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License Number State | AZ
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