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NPI 1649349440

NPI 1649349440 : DARIO LIZARRAGA M.D. : FLORENCE, AZ

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General NPI Number Information
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    NPI Number           |    1649349440
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    Entity Type          |    Individual 
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    Provider Name        |    DARIO LIZARRAGA M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/07/2006
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    Last Update Date     |    11/14/2013
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Provider Practice Location Address
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    Address Line         |    660 SOUTH MAIN STREET 
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    City                 |    FLORENCE
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    State                |    AZ
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    Zip                  |    85132
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    Country              |    US
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    Telephone            |    520-868-1400
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    Fax                  |    520-868-1500
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Provider Business Mailing Address
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    Address Line         |    PO BOX 2818 
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    City                 |    FLORENCE
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    State                |    AZ
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    Zip                  |    85132-3052
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    Country              |    US
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    Telephone            |    520-868-1400
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    Fax                  |    520-868-1400
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    0712660
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    License Number State |    AZ
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