Provider Demographics
NPI:1922292390
Name:UNIVERSITY OF ARIZONA MEDICAL CENTER
Entity Type:Organization
Organization Name:UNIVERSITY OF ARIZONA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INFECTIOUS DISEASE FELLOW
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:GIBLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:520-626-6887
Mailing Address - Street 1:1501 N CAMPBELL AVE
Mailing Address - Street 2:P.O. BOX 245039
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-0001
Mailing Address - Country:US
Mailing Address - Phone:520-626-6887
Mailing Address - Fax:520-626-5183
Practice Address - Street 1:UNIVERSITY OF ARIZONA DEPT OF INFECTIOUS DISEASE
Practice Address - Street 2:1501 N. CAMPBELL AVE
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:520-626-6887
Practice Address - Fax:520-626-5183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4703282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital