Provider Demographics
NPI:1417150624
Name:RAO, ARUN JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUN
Middle Name:JAY
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5170 E GLENN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1396
Mailing Address - Country:US
Mailing Address - Phone:520-209-2500
Mailing Address - Fax:520-545-7250
Practice Address - Street 1:5170 E GLENN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1396
Practice Address - Country:US
Practice Address - Phone:520-209-2500
Practice Address - Fax:520-545-7250
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082558208600000X, 390200000X
KY433102086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program