Provider Demographics
NPI:1750476974
Name:CHAVEZ, GENIFER Y (MD)
Entity Type:Individual
Prefix:DR
First Name:GENIFER
Middle Name:Y
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6226 E. PIMA RD.
Mailing Address - Street 2:SUITE 3
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712
Mailing Address - Country:US
Mailing Address - Phone:520-323-1600
Mailing Address - Fax:520-323-0736
Practice Address - Street 1:6226 E. PIMA RD.
Practice Address - Street 2:SUITE 3
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712
Practice Address - Country:US
Practice Address - Phone:520-323-1600
Practice Address - Fax:520-323-0736
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16259207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00173781OtherRAILROAD MEDICARE
AZP00173781OtherRAILROAD MEDICARE