MEDICARE: DESERT HEART SURGERY SPECIALISTS, PLLC

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	32835	AZ

General Provider Information

NPI Number	:	1184870560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT HEART SURGERY SPECIALISTS, PLLC

Provider Business Mailing Address
First Line	:	7850 N SILVERBELL RD STE 114-360
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-8219
Country	:	US
Telephone Number	:	520-222-8065
Fax Number	:	520-232-2313

Provider Business Practice Location Address
First Line	:	7850 N SILVERBELL RD STE 114-360
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-8219
Country	:	US
Telephone Number	:	520-222-8065
Fax Number	:	520-232-2313

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DEREK VON HAAG
Credential	:	M.D.
Telephone Number	:	520-222-8065

Provider Enumeration Date	:	08/17/2008
Last Update Date	:	04/17/2019

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