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NPI Code Detail

MEDICARE: TUCSON SPORTS MEDICINE AND ORTHOPEDIC SURGERY PLLC

MEDICARE: TUCSON SPORTS MEDICINE AND ORTHOPEDIC SURGERY 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
1207XX0005XSports Medicine (Orthopaedic Surgery) Physician
2207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1649941758
Entity Type Code : Organization
Provider Name (Legal Business Name) : TUCSON SPORTS MEDICINE AND ORTHOPEDIC SURGERY PLLC
Provider Business Mailing Address
First Line : 4880 N AVENIDA DE FRANELAH
Second Line :
City : TUCSON
State : AZ
Zip : 85749-8721
Country : US
Telephone Number : 520-869-4909
Fax Number :
Provider Business Practice Location Address
First Line : 1712 W ANKLAM RD STE 102
Second Line :
City : TUCSON
State : AZ
Zip : 85745-2660
Country : US
Telephone Number : 520-396-4798
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. RORY GARGUS
Credential :
Telephone Number : 520-869-4909
Provider Enumeration Date : 09/28/2021
Last Update Date : 09/28/2021

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Directions to “TUCSON SPORTS MEDICINE AND ORTHOPEDIC SURGERY PLLC ” Practice Location

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