Provider Demographics
NPI:1730290172
Name:BRODY, ERIC ARNOLD (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ARNOLD
Last Name:BRODY
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 1:445 N SILVERBELL RD STE 201
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2686
Mailing Address - Country:US
Mailing Address - Phone:520-396-1370
Mailing Address - Fax:
Practice Address - Street 1:445 N SILVERBELL RD STE 201
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2686
Practice Address - Country:US
Practice Address - Phone:520-396-1370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23618207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ398132Medicaid
NHF83161Medicare UPIN
AZ398132Medicaid