Provider Demographics
NPI:1821046251
Name:NOVALIS, GEORGE S (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:S
Last Name:NOVALIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6585 N ORACLE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-5611
Mailing Address - Country:US
Mailing Address - Phone:520-742-7444
Mailing Address - Fax:520-297-2267
Practice Address - Street 1:6585 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5611
Practice Address - Country:US
Practice Address - Phone:520-742-7444
Practice Address - Fax:520-297-2267
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2017-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ8416207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPOP19NOVAGE1OtherMERCY CARE
AZ696591OtherAETNA
AZAZ0376620OtherBLUE CROSS/BLUE SHIELD
AZ221664OtherAHCCCS
AZ0596890006OtherCIGNA
AZ221664OtherAHCCCS
AZPOP19NOVAGE1OtherMERCY CARE