Provider Demographics
NPI:1922125996
Name:JULIA V SALMON
Entity Type:Organization
Organization Name:JULIA V SALMON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:SALMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-623-2244
Mailing Address - Street 1:PO BOX 40365
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85717-0365
Mailing Address - Country:US
Mailing Address - Phone:520-623-2244
Mailing Address - Fax:520-792-2152
Practice Address - Street 1:1773 W SAINT MARYS RD
Practice Address - Street 2:SUITE 202
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2654
Practice Address - Country:US
Practice Address - Phone:520-623-2244
Practice Address - Fax:520-792-2152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ309965Medicaid
AZ65369Medicare ID - Type Unspecified
AZG02683Medicare UPIN