MEDICARE: ARIZONA ONCOLOGY

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	363A00000X	Physician Assistant	3579	AZ

General Provider Information

NPI Number	:	1154485530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA ONCOLOGY

Provider Business Mailing Address
First Line	:	1760 E RIVER RD
Second Line	:	SUITE 350
City	:	TUCSON
State	:	AZ
Zip	:	85718-5877
Country	:	US
Telephone Number	:	520-519-7720
Fax Number	:	520-519-5175

Provider Business Practice Location Address
First Line	:	1760 E RIVER RD
Second Line	:	SUITE 350
City	:	TUCSON
State	:	AZ
Zip	:	85718-5877
Country	:	US
Telephone Number	:	520-519-7720
Fax Number	:	520-519-5175

Authorized Official
Title or Position	:	PA
Name	:	MR. WILLIAM T RESSEGUIE
Credential	:	PA
Telephone Number	:	520-519-7720

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	12/03/2007

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