Provider Demographics
NPI:1235133182
Name:SIEGEL, DAVID B (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:SIEGEL
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 1:4727 E CAMP LOWELL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1256
Mailing Address - Country:US
Mailing Address - Phone:520-290-4263
Mailing Address - Fax:520-323-2716
Practice Address - Street 1:4727 E CAMP LOWELL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1256
Practice Address - Country:US
Practice Address - Phone:520-290-4263
Practice Address - Fax:520-323-2716
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2020-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21720207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ42301OtherHEALTH NET
AZ98236OtherPACIFICARE
AZ142505Medicaid
AZAZ0820910OtherBCBS
AZE10386OtherUNITED HEALTH CARE
AZAZ0820910OtherBCBS
AZE10386OtherUNITED HEALTH CARE