Basic Information
Provider Information
NPI: 1811086820
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SOKOL
FirstName: GEORGE
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 43160
Address2:  
City: TUCSON
State: AZ
PostalCode: 857333160
CountryCode: US
TelephoneNumber: 5207223777
FaxNumber: 5202966224
Practice Location
Address1: 1622 N SWAN RD
Address2:  
City: TUCSON
State: AZ
PostalCode: 857124047
CountryCode: US
TelephoneNumber: 5207958888
FaxNumber: 5207958892
Other Information
ProviderEnumerationDate: 10/11/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X6393AZY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home