Provider Demographics
NPI:1942473467
Name:DYER, BRIDGET A (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:A
Last Name:DYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N JACOBUS AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-8545
Mailing Address - Country:US
Mailing Address - Phone:520-784-3487
Mailing Address - Fax:
Practice Address - Street 1:1609 N. WARREN AVE
Practice Address - Street 2:FOB 220, ROOM 118
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719
Practice Address - Country:US
Practice Address - Phone:520-626-6312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ80900207P00000X
CAA117438207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine