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General NPI Number Information
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NPI Number | 1568213700
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Entity Type | Organization
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Legal Business Name | SUNBELT MEDICAL GROUP LLC
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Dates
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Enumeration Date | 03/27/2024
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 4739 N 1ST AVE
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City | TUCSON
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State | AZ
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Zip | 85718-5610
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Country | US
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Telephone | 520-614-6617
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Fax |
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Provider Business Mailing Address
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Address Line | 2850 N COUNTRY CLUB RD
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City | TUCSON
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State | AZ
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Zip | 85716-1910
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Country | US
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Telephone | 520-322-6274
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ED HUDSON
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Credential |
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Telephone | 520-322-6274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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