Provider Demographics
NPI:1629034566
Name:KAGEYAMA, DANA M (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:M
Last Name:KAGEYAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WOODMONT BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5250
Mailing Address - Country:US
Mailing Address - Phone:615-315-5257
Mailing Address - Fax:615-692-0547
Practice Address - Street 1:1740 E FORT LOWELL ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2384
Practice Address - Country:US
Practice Address - Phone:520-613-0001
Practice Address - Fax:520-613-0003
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25676207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ112349Medicare PIN
AZZ74263Medicare PIN
H13748Medicare UPIN