Provider Demographics
NPI:1457670440
Name:MENEZES, ARTHUR R (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:R
Last Name:MENEZES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:3709 N CAMPBELL AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1563
Mailing Address - Country:US
Mailing Address - Phone:520-838-2212
Mailing Address - Fax:520-838-2245
Practice Address - Street 1:1714 W ANKLAM RD STE 104
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2690
Practice Address - Country:US
Practice Address - Phone:520-624-8935
Practice Address - Fax:520-624-0053
Is Sole Proprietor?:No
Enumeration Date:2010-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ54176207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ259799Medicaid