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General NPI Number Information
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NPI Number | 1578512257
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Entity Type | Individual
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Provider Name | JOHN THADDEUS DECKER MD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 6452 E CARONDELET DR STE 100
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City | TUCSON
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State | AZ
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Zip | 85710-2262
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Country | US
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Telephone | 520-323-0333
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Fax | 520-323-5036
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Provider Business Mailing Address
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Address Line | 2424 N WYATT DR STE 260
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City | TUCSON
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State | AZ
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Zip | 85712-6118
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Country | US
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Telephone | 520-795-8080
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Fax | 520-323-6237
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 25939
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License Number State | AZ
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