Provider Demographics
NPI:1164457792
Name:VETTER, SALLY J (MD)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:J
Last Name:VETTER
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Gender:F
Credentials:MD
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Mailing Address - Street 1:ORO VALLEY ANESTHESIA PLLC
Mailing Address - Street 2:DEPT 9538
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90084-9538
Mailing Address - Country:US
Mailing Address - Phone:520-529-0313
Mailing Address - Fax:520-901-3642
Practice Address - Street 1:1551 E TANGERINE RD
Practice Address - Street 2:ATTN MEDICAL STAFF SERVICES
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755
Practice Address - Country:US
Practice Address - Phone:520-901-3559
Practice Address - Fax:520-901-3642
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2017-02-10
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Provider Licenses
StateLicense IDTaxonomies
AZ26216207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ100737Medicare PIN
AZZ197939Medicare PIN