Provider Demographics
NPI:1093885477
Name:ALVERNON ALLERGY AND ASTHMA, P.C.
Entity Type:Organization
Organization Name:ALVERNON ALLERGY AND ASTHMA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KUDAGAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MURTHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-322-8361
Mailing Address - Street 1:2902 E GRANT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-2742
Mailing Address - Country:US
Mailing Address - Phone:520-322-8361
Mailing Address - Fax:520-322-8462
Practice Address - Street 1:2902 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2742
Practice Address - Country:US
Practice Address - Phone:520-322-8361
Practice Address - Fax:520-322-8462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ=========OtherEIN