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General NPI Number Information
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NPI Number | 1639720063
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Entity Type | Organization
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Legal Business Name | SOUTHERN ARIZONA LABORISTS, LLC
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Dates
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Enumeration Date | 09/26/2019
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 1171 W TARGET RANGE RD
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City | NOGALES
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State | AZ
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Zip | 85621-2415
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Country | US
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Telephone | 520-348-0938
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Fax | 520-512-5401
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Provider Business Mailing Address
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Address Line | 3430 E SUNRISE DR STE 180
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City | TUCSON
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State | AZ
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Zip | 85718-3236
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Country | US
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Telephone | 520-348-0938
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Fax | 520-512-5401
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ELIZABETH WEISERT
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Credential | MD
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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