Provider Demographics
NPI:1790764843
Name:SCHWARTZ, TISHA KATHLEEN ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:TISHA
Middle Name:KATHLEEN ANN
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1200 N EL DORADO PLACE
Mailing Address - Street 2:F-670
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-4637
Mailing Address - Country:US
Mailing Address - Phone:520-324-4774
Mailing Address - Fax:520-324-2567
Practice Address - Street 1:6226 E PIMA STREET
Practice Address - Street 2:#3
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-7002
Practice Address - Country:US
Practice Address - Phone:520-320-1200
Practice Address - Fax:520-320-1222
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2010-11-04
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Provider Licenses
StateLicense IDTaxonomies
AZ33950207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ948044Medicare ID - Type Unspecified
H85585Medicare UPIN
104213Medicare ID - Type Unspecified