Provider Demographics
NPI:1649616566
Name:UNIVERSITY OF ARIZONA
Entity type:Organization
Organization Name:UNIVERSITY OF ARIZONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR, DEPT. OF PATH.
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:UMSTOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-626-6830
Mailing Address - Street 1:210 E 2ND ST
Mailing Address - Street 2:#2
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-7773
Mailing Address - Country:US
Mailing Address - Phone:814-602-0167
Mailing Address - Fax:
Practice Address - Street 1:210 E 2ND ST
Practice Address - Street 2:#2
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-7773
Practice Address - Country:US
Practice Address - Phone:814-602-0167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-19
Last Update Date:2013-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR73832207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty