Provider Demographics
NPI:1578208393
Name:ZIMON, ATHENA SINEAD WILSON (MD)
Entity Type:Individual
Prefix:
First Name:ATHENA
Middle Name:SINEAD WILSON
Last Name:ZIMON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ATHENA
Other - Middle Name:SINEAD
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3950 S COUNTRY CLUB RD STE 200
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85714-2227
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3950 S COUNTRY CLUB RD STE 200
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-2227
Practice Address - Country:US
Practice Address - Phone:520-874-2778
Practice Address - Fax:520-874-4801
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR79521207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine