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NPI Code Detail

MEDICARE: GEORGE S. NOVALIS M.D.

MEDICARE:   GEORGE S. NOVALIS  M.D.
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
1207WX0107XRetina Specialist (Ophthalmology) Physician8416AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1POP19NOVAGE1OTHERAZMERCY CARE
2696591OTHERAZAETNA
3AZ0376620OTHERAZBLUE CROSS/BLUE SHIELD
4221664OTHERAZAHCCCS
50596890006OTHERAZCIGNA

General Provider Information

NPI Number : 1821046251
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE S. NOVALIS M.D.
Provider Business Mailing Address
First Line : 6585 N ORACLE RD
Second Line :
City : TUCSON
State : AZ
Zip : 85704-5611
Country : US
Telephone Number : 520-742-7444
Fax Number : 520-297-2267
Provider Business Practice Location Address
First Line : 6585 N ORACLE RD
Second Line :
City : TUCSON
State : AZ
Zip : 85704-5611
Country : US
Telephone Number : 520-742-7444
Fax Number : 520-297-2267
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 04/04/2017

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Directions to “ GEORGE S. NOVALIS M.D.” Practice Location

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