Provider Demographics
NPI:1801983473
Name:UZCATEGUI, NICOLAS (MD)
Entity type:Individual
Prefix:
First Name:NICOLAS
Middle Name:
Last Name:UZCATEGUI
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 1:7245 E OSBORN RD STE 4
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6443
Mailing Address - Country:US
Mailing Address - Phone:480-994-5012
Mailing Address - Fax:480-994-9479
Practice Address - Street 1:7245 E OSBORN RD STE 4
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6443
Practice Address - Country:US
Practice Address - Phone:480-994-5012
Practice Address - Fax:480-994-9479
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ53806207W00000X, 207WX0200X
NY250473207W00000X, 207WX0200X
CAA72027207WX0200X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A720270Medicaid
AZ247118Medicaid