Provider Demographics
NPI:1649341785
Name:DEMETREE, JULIE M (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:M
Last Name:DEMETREE
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:PO BOX 245002
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-5002
Mailing Address - Country:US
Mailing Address - Phone:520-626-3819
Mailing Address - Fax:
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:352-262-7575
Practice Address - Fax:704-755-1834
Is Sole Proprietor?:No
Enumeration Date:2006-11-12
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5110482084P0800X
VA01012723752084P0800X
AZ481282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ857634Medicaid
AZ857634Medicaid