Provider Demographics
NPI:1851764328
Name:BANNER UNIVERSITY MEDICAL CENTER-TUCSON
Entity Type:Organization
Organization Name:BANNER UNIVERSITY MEDICAL CENTER-TUCSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:BAUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-602-0167
Mailing Address - Street 1:1303 E UNIVERSITY BLVD
Mailing Address - Street 2:BOX 4
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-0521
Mailing Address - Country:US
Mailing Address - Phone:520-874-7500
Mailing Address - Fax:
Practice Address - Street 1:1303 E UNIVERSITY BLVD
Practice Address - Street 2:BOX 4
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-0521
Practice Address - Country:US
Practice Address - Phone:520-874-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR73832282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital