Provider Demographics
NPI:1124033592
Name:CADOUX, ALEXANDER PETER (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:PETER
Last Name:CADOUX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 E SKYLINE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-8006
Mailing Address - Country:US
Mailing Address - Phone:520-529-9665
Mailing Address - Fax:520-529-9669
Practice Address - Street 1:2870 E SKYLINE DR STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-8006
Practice Address - Country:US
Practice Address - Phone:520-529-9665
Practice Address - Fax:520-529-9669
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27029208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ26863Medicare ID - Type Unspecified
AZD95950Medicare UPIN