MEDICARE: PATRICK MICHAEL NOONAN D.O.

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	207R00000X	Internal Medicine Physician	006187	AZ
2	207R00000X	Internal Medicine Physician	4340	IA
3	207R00000X	Internal Medicine Physician	R-8981	IA

General Provider Information

NPI Number	:	1346561040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK MICHAEL NOONAN D.O.

Provider Business Mailing Address
First Line	:	4955 N SABINO CANYON RD STE 103
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750-6491
Country	:	US
Telephone Number	:	520-314-2400
Fax Number	:	520-657-1477

Provider Business Practice Location Address
First Line	:	4955 N SABINO CANYON RD STE 103
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750-6491
Country	:	US
Telephone Number	:	520-375-9811
Fax Number	:

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

Provider Enumeration Date	:	06/16/2010
Last Update Date	:	12/16/2025

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