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General NPI Number Information
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NPI Number | 1558363465
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Entity Type | Organization
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Legal Business Name | IRONWOOD DERMATOLOGY, PC
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 07/05/2011
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Provider Practice Location Address
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Address Line | 1735 E SKYLINE DR
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City | TUCSON
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State | AZ
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Zip | 85718-1162
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Country | US
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Telephone | 520-618-1630
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Fax |
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Provider Business Mailing Address
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Address Line | 1735 E SKYLINE DR
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City | TUCSON
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State | AZ
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Zip | 85718-1162
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Country | US
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Telephone | 520-618-1630
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Fax |
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | FIONA J BEHR
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Credential | M.D
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Telephone | 520-618-1630
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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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