MEDICARE: ORO VALLEY ADULT AND CHILD NEUROLOGY 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	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	32365	AZ

General Provider Information

NPI Number	:	1366592420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORO VALLEY ADULT AND CHILD NEUROLOGY PLLC

Provider Business Mailing Address
First Line	:	PO BOX 43100
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85733-3100
Country	:	US
Telephone Number	:	520-722-3777
Fax Number	:	520-296-6224

Provider Business Practice Location Address
First Line	:	13101 N ORACLE RD
Second Line	:	SUITE 109
City	:	TUCSON
State	:	AZ
Zip	:	85739-9554
Country	:	US
Telephone Number	:	520-825-8275
Fax Number	:	520-825-3760

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STUART A STEIN
Credential	:	MD
Telephone Number	:	520-825-8275

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	07/07/2010

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