MEDICARE: DR. GAIL N SHULTZ 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
1	207QA0401X	Addiction Medicine (Family Medicine) Physician	6192	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1861592826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAIL N SHULTZ M.D.

Provider Business Mailing Address
First Line	:	6838 N CORTE CALABAZA
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-4141
Country	:	US
Telephone Number	:	520-743-0411
Fax Number	:

Provider Business Practice Location Address
First Line	:	4110 W SWEETWATER DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-9348
Country	:	US
Telephone Number	:	520-743-0411
Fax Number	:

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/09/2007

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