Provider Demographics
NPI:1356495105
Name:ADOBE DERMATOLOGY, PC
Entity Type:Organization
Organization Name:ADOBE DERMATOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:G
Authorized Official - Last Name:SILVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-795-3800
Mailing Address - Street 1:PO BOX 30370
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-0370
Mailing Address - Country:US
Mailing Address - Phone:520-722-0777
Mailing Address - Fax:520-290-9713
Practice Address - Street 1:5155 E FARNESS DR
Practice Address - Street 2:SUITE 111B
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2158
Practice Address - Country:US
Practice Address - Phone:520-795-3800
Practice Address - Fax:520-795-3806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22332207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ175366Medicaid
AZAZ0885160OtherBCBSAZ
AZAZ0885160OtherBCBSAZ
AZ175366Medicaid