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General NPI Number Information
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NPI Number | 1932454881
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Entity Type | Organization
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Legal Business Name | LEY INSTITUTE OF PLASTIC & HAND SURGERY, LLC
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 07/17/2012
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Provider Practice Location Address
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Address Line | 1517 N WILMOT RD 177
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City | TUCSON
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State | AZ
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Zip | 85712-4410
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Country | US
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Telephone | 520-396-3566
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Fax | 801-396-3548
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Provider Business Mailing Address
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Address Line | 5225 E KNIGHT DR SUITE 201
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City | TUCSON
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State | AZ
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Zip | 85712-2156
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Country | US
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Telephone | 520-396-3566
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Fax | 801-396-3548
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. ELEAZAR LEY TAI
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Credential | M.D.
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Telephone | 801-651-8782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 36876
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License Number State | AZ
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