MEDICARE: DERMATOLOGY CENTER PC

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	207N00000X	Dermatology Physician	21281	AZ

General Provider Information

NPI Number	:	1235116195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DERMATOLOGY CENTER PC

Provider Business Mailing Address
First Line	:	7005 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-4329
Country	:	US
Telephone Number	:	520-498-1818
Fax Number	:	520-575-8777

Provider Business Practice Location Address
First Line	:	7005 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-4329
Country	:	US
Telephone Number	:	520-498-1818
Fax Number	:	520-575-8777

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT J SEGAL
Credential	:	MD
Telephone Number	:	520-498-1818

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	08/22/2020

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