MEDICARE: DR. KRISTIN W LORENZ DO

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	207Q00000X	Family Medicine Physician	2769	AZ

General Provider Information

NPI Number	:	1598723249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTIN W LORENZ DO

Provider Business Mailing Address
First Line	:	5055 E BROADWAY BLVD
Second Line	:	STE A-100
City	:	TUCSON
State	:	AZ
Zip	:	85711-3640
Country	:	US
Telephone Number	:	520-327-0460
Fax Number	:	520-795-0225

Provider Business Practice Location Address
First Line	:	4532 E CAMP LOWELL DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-1282
Country	:	US
Telephone Number	:	520-547-1887
Fax Number	:	520-547-1893

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	01/16/2020

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