Provider Demographics
NPI:1770546392
Name:DECHANT, CURTIS PHILIP (OD)
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:PHILIP
Last Name:DECHANT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7475 E TANQUE VERDE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3477
Mailing Address - Country:US
Mailing Address - Phone:520-663-5393
Mailing Address - Fax:520-663-1023
Practice Address - Street 1:7475 E TANQUE VERDE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3477
Practice Address - Country:US
Practice Address - Phone:520-663-5393
Practice Address - Fax:520-663-1023
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1175152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ832297Medicaid
AZU66739Medicare UPIN
AZP00120739Medicare PIN
AZ832297Medicaid
AZ5134350001Medicare NSC