Provider Demographics
NPI:1346839214
Name:AMA FAMILY PRACTICE PLLC
Entity Type:Organization
Organization Name:AMA FAMILY PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:COULIBALY DIT FALL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:520-256-7028
Mailing Address - Street 1:6600 N ORACLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-5676
Mailing Address - Country:US
Mailing Address - Phone:520-575-9007
Mailing Address - Fax:520-575-0041
Practice Address - Street 1:6600 N ORACLE RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5676
Practice Address - Country:US
Practice Address - Phone:520-575-9007
Practice Address - Fax:520-575-0041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care