Provider Demographics
NPI:1811477235
Name:PRICE, ALAN THATCHER (IDMT)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:THATCHER
Last Name:PRICE
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5020 E ARIZOLA ST BLDG 1631
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85707-3108
Mailing Address - Country:US
Mailing Address - Phone:520-228-7812
Mailing Address - Fax:520-228-7804
Practice Address - Street 1:4175 S ALAMO AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85707-4402
Practice Address - Country:US
Practice Address - Phone:520-228-4910
Practice Address - Fax:520-228-0169
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians