MEDICARE: SUNBELT OCCUPATIONAL HEALTH, LLC

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	225X00000X	Occupational Therapist
2	2083X0100X	Occupational Medicine Physician

General Provider Information

NPI Number	:	1346828514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNBELT OCCUPATIONAL HEALTH, LLC

Provider Business Mailing Address
First Line	:	2850 N COUNTRY CLUB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-1910
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 N TUCSON BLVD STE 40
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-3410
Country	:	US
Telephone Number	:	520-488-4808
Fax Number	:	520-207-6200

Authorized Official
Title or Position	:	CFO, COO
Name	:	EDWARD J HUDSON
Credential	:
Telephone Number	:	520-907-4817

Provider Enumeration Date	:	03/30/2021
Last Update Date	:	04/07/2021

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