Provider Demographics
NPI:1336149277
Name:SCHILLING, JOLYON DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JOLYON
Middle Name:DAVID
Last Name:SCHILLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6524 E SANTA AURELIA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3126
Mailing Address - Country:US
Mailing Address - Phone:520-320-5665
Mailing Address - Fax:520-320-1377
Practice Address - Street 1:5240 E KNIGHT DR
Practice Address - Street 2:SUITE 116
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2122
Practice Address - Country:US
Practice Address - Phone:520-320-5665
Practice Address - Fax:520-320-1377
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ201462086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
E77194Medicare UPIN
AZ66567Medicare ID - Type Unspecified