Provider Demographics
NPI:1598724163
Name:FUHR-DECHANT, AMY MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:MARIE
Last Name:FUHR-DECHANT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7475 E TANQUE VERDE RD.
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715
Mailing Address - Country:US
Mailing Address - Phone:520-663-5393
Mailing Address - Fax:520-663-1023
Practice Address - Street 1:7475 E TANQUE VERDE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3477
Practice Address - Country:US
Practice Address - Phone:520-663-5393
Practice Address - Fax:520-663-1023
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1109152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ832304Medicaid
AZU74483Medicare UPIN
AZP00120739Medicare PIN
AZZ78641Medicare ID - Type Unspecified
AZ5134350001Medicare NSC