Provider Demographics
NPI:1851828115
Name:SOUTHERN ARIZONA TOXICOLOGY ASSOCIATES PLLC
Entity Type:Organization
Organization Name:SOUTHERN ARIZONA TOXICOLOGY ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ORI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-425-3112
Mailing Address - Street 1:4934 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4934 E 12TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-3606
Practice Address - Country:US
Practice Address - Phone:520-425-3112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical ToxicologyGroup - Single Specialty