MEDICARE: DR. JUDITH EVELYN RILEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	13749	AZ

General Provider Information

NPI Number	:	1073570602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH EVELYN RILEY MD

Provider Business Mailing Address
First Line	:	310 N WILMOT RD
Second Line	:	SUITE 306
City	:	TUCSON
State	:	AZ
Zip	:	85711-2618
Country	:	US
Telephone Number	:	520-325-0865
Fax Number	:	520-325-4281

Provider Business Practice Location Address
First Line	:	310 N WILMOT RD
Second Line	:	SUITE 306
City	:	TUCSON
State	:	AZ
Zip	:	85711-2618
Country	:	US
Telephone Number	:	520-325-0865
Fax Number	:	520-325-4281

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	01/10/2008

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Directions to “ DR. JUDITH EVELYN RILEY MD” Practice Location

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