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General NPI Number Information
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NPI Number | 1982084562
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Entity Type | Organization
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Legal Business Name | CJ SURGICAL ASSISTING
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Dates
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Enumeration Date | 06/09/2015
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Last Update Date | 06/09/2015
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Provider Practice Location Address
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Address Line | 9420 E. GOLF LINKS RD. STE 108 #138
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City | TUCSON
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State | AZ
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Zip | 85730-1317
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Country | US
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Telephone | 520-390-3862
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Fax |
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Provider Business Mailing Address
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Address Line | 9420 E. GOLF LINKS RD. STE 108 #138
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City | TUCSON
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State | AZ
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Zip | 85873-1317
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Country | US
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Telephone | 520-390-3862
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CAROLYN L JONES
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Credential | SA-C
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Telephone | 520-390-3862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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