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NPI Code Detail

MEDICARE: TLC HEALTHCARE MEDICAL GROUP PC

MEDICARE: TLC HEALTHCARE MEDICAL GROUP PC
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
1207QG0300XGeriatric Medicine (Family Medicine) Physician20393AZ
2207R00000XInternal Medicine Physician
3207RG0300XGeriatric Medicine (Internal Medicine) Physician
4207RG0300XGeriatric Medicine (Internal Medicine) Physician20393AZ
5207QG0300XGeriatric Medicine (Family Medicine) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720157464
Entity Type Code : Organization
Provider Name (Legal Business Name) : TLC HEALTHCARE MEDICAL GROUP PC
Provider Business Mailing Address
First Line : 2850 NORTH COUNTRY CLUB ROAD
Second Line :
City : TUCSON
State : AZ
Zip : 85716-1910
Country : US
Telephone Number : 520-322-6274
Fax Number : 520-509-4496
Provider Business Practice Location Address
First Line : 5130 NORTH CIRCULO SOBRIO
Second Line :
City : TUCSON
State : AZ
Zip : 85718-6036
Country : US
Telephone Number : 520-670-0745
Fax Number : 520-509-4496
Authorized Official
Title or Position : OWNER/AUTHORIZED OFFICIAL
Name : DR. SCOTT M BOLHACK
Credential : MD
Telephone Number : 520-670-0745
Provider Enumeration Date : 11/07/2006
Last Update Date : 03/22/2019

Similar Medicare Providers

1730160573 — SCOTT M BOLHACK MD
Practice Location Address:
5130 NORTH CIRCULO SOBRIO
TUCSON, AZ
85718-6036
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1699918235 — TLC HEALTHCARE WOUND SPECIALISTS INC
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1124326558 — WEST AJO MEDICAL CENTER LTD.
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101 W AJO WAY
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85713-6036
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Practice Fax: 520-573-0440
1679116545 — ALBERT R. FRITZ III D.O. P.L.L.C.
Practice Location Address:
101 W AJO WAY
TUCSON, AZ
85713-6036
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Practice Fax: 520-573-0440
1831709302 — NAMPHUENG MCKAY
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165 W AJO WAY
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85713-6036
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Practice Fax:
1962380196 — SONORAN WELLNESS PRIMARY CARE PLLC
Practice Location Address:
1760 E RIVER RD STE 135
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85718-5988
Practice Phone: 520-542-2654
Practice Fax: 520-526-1153

Directions to “TLC HEALTHCARE MEDICAL GROUP PC ” Practice Location

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