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General NPI Number Information
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NPI Number | 1558216093
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Entity Type | Organization
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Legal Business Name | WILLOW DERMATOLOGY, PLLC
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/08/2026
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Provider Practice Location Address
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Address Line | 12702 N PIPING ROCK RD
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City | ORO VALLEY
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State | AZ
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Zip | 85755-6769
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Country | US
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Telephone | 520-314-4092
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Fax |
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Provider Business Mailing Address
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Address Line | 12702 N PIPING ROCK RD
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City | ORO VALLEY
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State | AZ
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Zip | 85755-6769
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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 | DOCTOR/CO-OWNER
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Name | DR. MOHAMMAD FAZEL
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Credential | MD, PHARMD
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Telephone | 520-314-4092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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