MEDICARE: NEUROLOGICAL ASSOCIATES OF TUCSON

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	207RS0012X	Sleep Medicine (Internal Medicine) Physician	35720	AZ
2	207YX0901X	Otology & Neurotology Physician	44630	AZ
3	2084N0400X	Neurology Physician
4	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician
5	2085R0001X	Radiation Oncology Physician	42470	AZ
6	208VP0014X	Interventional Pain Medicine Physician
7	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1669588158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGICAL ASSOCIATES OF TUCSON

Provider Business Mailing Address
First Line	:	2450 E RIVER RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-6522
Country	:	US
Telephone Number	:	520-795-7923
Fax Number	:	520-320-2155

Provider Business Practice Location Address
First Line	:	2450 E RIVER RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-6522
Country	:	US
Telephone Number	:	520-795-7923
Fax Number	:	520-320-2155

Authorized Official
Title or Position	:	EXECUTIVE ASSISTANT
Name	:	SCARLETT JARGO
Credential	:
Telephone Number	:	520-795-7750

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	06/21/2024

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