Provider Demographics
NPI:1144573189
Name:UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE AT SOUTH CAMPUS
Entity Type:Organization
Organization Name:UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE AT SOUTH CAMPUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR OF GME
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEINERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-874-2995
Mailing Address - Street 1:14441 S CAMINO EL GALAN
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8495
Mailing Address - Country:US
Mailing Address - Phone:954-665-4733
Mailing Address - Fax:
Practice Address - Street 1:2800 E AJO WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-6204
Practice Address - Country:US
Practice Address - Phone:520-874-4276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2014-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital