Provider Demographics
NPI:1023001567
Name:ROY R. GETTEL MDPLLC
Entity Type:Organization
Organization Name:ROY R. GETTEL MDPLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:GETTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD PLLC
Authorized Official - Phone:520-742-0900
Mailing Address - Street 1:1980 W HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7804
Mailing Address - Country:US
Mailing Address - Phone:520-742-0900
Mailing Address - Fax:520-742-1371
Practice Address - Street 1:1980 W HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7802
Practice Address - Country:US
Practice Address - Phone:520-742-0900
Practice Address - Fax:520-742-1371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11015174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0000BGJFGMedicare ID - Type Unspecified