MEDICARE: DR. GARY LEE HURWITZ M.D.

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	207P00000X	Emergency Medicine Physician	MD00037298	WA

General Provider Information

NPI Number	:	1225012321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY LEE HURWITZ M.D.

Provider Business Mailing Address
First Line	:	12400 E 8TH ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85748-7134
Country	:	US
Telephone Number	:	520-722-7098
Fax Number	:

Provider Business Practice Location Address
First Line	:	4175 S ALAMO AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85707-6097
Country	:	US
Telephone Number	:	520-228-2719
Fax Number	:	520-228-1549

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	07/08/2007

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