Provider Demographics
NPI:1043298656
Name:MORALES, MONTY C (MD)
Entity Type:Individual
Prefix:DR
First Name:MONTY
Middle Name:C
Last Name:MORALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3709 N CAMPBELL AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1563
Mailing Address - Country:US
Mailing Address - Phone:520-838-2138
Mailing Address - Fax:520-838-2260
Practice Address - Street 1:2404 E RIVER RD
Practice Address - Street 2:BLDG 2, STE 100
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-6520
Practice Address - Country:US
Practice Address - Phone:520-696-4780
Practice Address - Fax:520-293-7024
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ21549207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ136681Medicaid
AZZ20460Medicare PIN
AZZ20459Medicare PIN
F21027Medicare UPIN
AZZ20461Medicare PIN