Provider Demographics
NPI:1639140965
Name:GERALD ALTSCHULER MD PC
Entity Type:Organization
Organization Name:GERALD ALTSCHULER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTSCHULER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-888-3032
Mailing Address - Street 1:4733 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:TUSCON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5610
Mailing Address - Country:US
Mailing Address - Phone:520-888-3032
Mailing Address - Fax:520-888-9479
Practice Address - Street 1:4733 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:TUSCON
Practice Address - State:AZ
Practice Address - Zip Code:85718-5610
Practice Address - Country:US
Practice Address - Phone:520-888-3032
Practice Address - Fax:520-888-9479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4799207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ219982Medicaid
C99061Medicare UPIN