Provider Demographics
NPI:1942449558
Name:GADDI, ANTHONY P (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:P
Last Name:GADDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 N WYATT DR STE 260
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6118
Mailing Address - Country:US
Mailing Address - Phone:520-545-0608
Mailing Address - Fax:
Practice Address - Street 1:6565 E CARONDELET DR STE 300
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2158
Practice Address - Country:US
Practice Address - Phone:520-323-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ49696207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ172809Medicare PIN