Basic Information
| Provider Information | |||||||||
| NPI: | 1881050953 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PULMONARY INSTITUTE OF ARIZONA PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1951 N WILMOT RD | ||||||||
| Address2: | BLDG 4 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857128000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203181114 | ||||||||
| FaxNumber: | 5203822999 | ||||||||
| Practice Location | |||||||||
| Address1: | 1951 N WILMOT RD | ||||||||
| Address2: | BLDG 4 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857128000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203181114 | ||||||||
| FaxNumber: | 5203184693 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2016 | ||||||||
| LastUpdateDate: | 01/23/2019 | ||||||||
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| AuthorizedOfficialLastName: | REYES | ||||||||
| AuthorizedOfficialFirstName: | NATHANIEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5203181114 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0012X | AZ | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 363L00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 207RC0200X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 363LF0000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 207RP1001X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.