MEDICARE: DAFNEY DAVARE

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	208600000X	Surgery Physician	46172	AZ
2	2086S0127X	Trauma Surgery Physician	ME116100	FL
3	2086S0127X	Trauma Surgery Physician	46172	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	:	1861771610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAFNEY DAVARE

Provider Business Mailing Address
First Line	:	6130 N LA CHOLLA BLVD STE 210
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-3574
Country	:	US
Telephone Number	:	520-797-6881
Fax Number	:

Provider Business Practice Location Address
First Line	:	6130 N LA CHOLLA BLVD STE 210
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-3574
Country	:	US
Telephone Number	:	520-797-6881
Fax Number	:

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

Provider Enumeration Date	:	08/11/2011
Last Update Date	:	09/13/2021

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Directions to “ DAFNEY DAVARE ” Practice Location

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