Provider Demographics
NPI:1336244052
Name:GUERRA, ROBERT JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMES
Last Name:GUERRA
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 1:7022 N CORTE DEL ANUNCIO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-7333
Mailing Address - Country:US
Mailing Address - Phone:520-297-7090
Mailing Address - Fax:
Practice Address - Street 1:SOUTHERN ARIZONA VETERANS ADMINISTRATION HEALTH CARE
Practice Address - Street 2:3601 S. 6TH AVE.
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85723-0001
Practice Address - Country:US
Practice Address - Phone:520-629-4602
Practice Address - Fax:520-629-4603
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10189208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ203208Medicaid
AZ21856Medicare ID - Type Unspecified
AZD36959Medicare UPIN