Provider Demographics
NPI:1225350788
Name:ESPINOSA MORAZAN, ALLAN V (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:V
Last Name:ESPINOSA MORAZAN
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:PO BOX 910221
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-0221
Mailing Address - Country:US
Mailing Address - Phone:520-519-7700
Mailing Address - Fax:
Practice Address - Street 1:5430 LANDMARK LN
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-0019
Practice Address - Country:US
Practice Address - Phone:928-775-9430
Practice Address - Fax:928-775-9431
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35130221207RX0202X
AZ61846207RX0202X
ME131019207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology