MEDICARE: TIFFANY KIMIKO THORNTON MD

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	207L00000X	Anesthesiology Physician	R73309	AZ

General Provider Information

NPI Number	:	1689936296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY KIMIKO THORNTON MD

Provider Business Mailing Address
First Line	:	5780 N SWAN RD STE 180
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-4530
Country	:	US
Telephone Number	:	520-448-9490
Fax Number	:	520-448-9492

Provider Business Practice Location Address
First Line	:	5780 N SWAN RD STE 180
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-4530
Country	:	US
Telephone Number	:	520-448-9490
Fax Number	:	520-448-9492

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

Provider Enumeration Date	:	06/10/2012
Last Update Date	:	07/17/2025

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