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General NPI Number Information
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NPI Number | 1528254166
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Entity Type | Organization
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Legal Business Name | J THAD DECKER MD PLLC
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 6567 EAST CORONDELET STE 455
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City | TUCSON
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State | AZ
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Zip | 85710-6155
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Country | US
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Telephone | 520-886-6486
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Fax | 520-296-4132
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Provider Business Mailing Address
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Address Line | 3938 EAST GRANT ROAD STE 248
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City | TUCSON
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State | AZ
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Zip | 85712-2559
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Country | US
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Telephone | 520-298-3006
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Fax | 520-296-4132
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | DR. JOHN THADDEUS DECKER
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Credential | MD
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Telephone | 520-886-6486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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