Provider Demographics
NPI:1790779940
Name:HUEMPFNER, WENDY A (MD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:A
Last Name:HUEMPFNER
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 1:6001 E. GRANT RD.
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712
Mailing Address - Country:US
Mailing Address - Phone:520-745-6513
Mailing Address - Fax:520-733-1017
Practice Address - Street 1:1951 N. WILMOT RD.
Practice Address - Street 2:BLDG. #1 STE. #2
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2316
Practice Address - Country:US
Practice Address - Phone:520-722-3777
Practice Address - Fax:520-296-6224
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18840174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ045098Medicaid
AZE85972Medicare UPIN
AZZ29174Medicare PIN
AZZ128112Medicare PIN