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General NPI Number Information
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NPI Number | 1972834984
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Entity Type | Organization
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Legal Business Name | CARONDELET MEDICAL GROUP INC
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Dates
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Enumeration Date | 01/15/2010
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Last Update Date | 08/04/2010
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Provider Practice Location Address
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Address Line | 630 N ALVERNON WAY STE 251
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City | TUCSON
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State | AZ
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Zip | 85711-1879
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Country | US
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Telephone | 520-319-3283
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Fax | 520-319-3982
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Provider Business Mailing Address
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Address Line | PO BOX 29347
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City | PHOENIX
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State | AZ
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Zip | 85038-9347
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Country | US
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Telephone | 520-872-7000
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Fax | 520-872-7969
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Authorized Official
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Title or Position | SENIOR VICE PRESIDENT
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Name | PAULA REGISTER
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Credential |
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Telephone | 520-872-7076
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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 | 0585
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 647
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0666
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0546
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License Number State | AZ
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