Provider Demographics
NPI:1932636123
Name:TUCSON DIGESTIVE INSTITUTE LLC
Entity Type:Organization
Organization Name:TUCSON DIGESTIVE INSTITUTE LLC
Other - Org Name:ARIZONA DIGESTIVE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-567-0269
Mailing Address - Street 1:7566 N LA CHOLLA BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-6491
Mailing Address - Country:US
Mailing Address - Phone:520-547-5847
Mailing Address - Fax:
Practice Address - Street 1:7566 N LA CHOLLA BLVD STE B
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741
Practice Address - Country:US
Practice Address - Phone:520-742-4139
Practice Address - Fax:520-742-0814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-18
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical