1508279316 NPI number — ARIZONA ONCOLOGY ASSOCIATES PC

Table of content: (NPI 1508279316)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508279316 NPI number — ARIZONA ONCOLOGY ASSOCIATES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARIZONA ONCOLOGY ASSOCIATES PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508279316
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1760 E RIVER RD
Provider Second Line Business Mailing Address:
STE. # 350
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85718-5877
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-519-7775
Provider Business Mailing Address Fax Number:
520-519-7910

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2070 W RUDASILL RD
Provider Second Line Business Practice Location Address:
STE. # 130
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85704-7891
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-797-4468
Provider Business Practice Location Address Fax Number:
520-797-4502
Provider Enumeration Date:
06/09/2014

Additional Information

Authorized Official

Authorized Official Last Name:
BUSCEMA
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE PRESIDENT
Authorized Official Telephone Number:
520-886-0206

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 289515 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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