Provider Demographics
NPI:1013094218
Name:SCHWARTZ, GAIL L (MD)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:L
Last Name:SCHWARTZ
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 1:6812 N ORACLE RD STE 114
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4230
Mailing Address - Country:US
Mailing Address - Phone:520-544-4245
Mailing Address - Fax:520-297-2242
Practice Address - Street 1:6812 N ORACLE RD STE 114
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4230
Practice Address - Country:US
Practice Address - Phone:520-544-4245
Practice Address - Fax:520-297-2242
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19615174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0738120OtherBLUE CROSS BLUE SHIELD
E18964Medicare UPIN
73316Medicare ID - Type Unspecified