Provider Demographics
NPI:1881050953
Name:PULMONARY INSTITUTE OF ARIZONA PC
Entity type:Organization
Organization Name:PULMONARY INSTITUTE OF ARIZONA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-318-1114
Mailing Address - Street 1:1951 N WILMOT RD
Mailing Address - Street 2:BLDG 4
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-8000
Mailing Address - Country:US
Mailing Address - Phone:520-318-1114
Mailing Address - Fax:520-382-2999
Practice Address - Street 1:1951 N WILMOT RD
Practice Address - Street 2:BLDG 4
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-8000
Practice Address - Country:US
Practice Address - Phone:520-318-1114
Practice Address - Fax:520-318-4693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207RS0012X
363L00000X, 207RC0200X, 363LF0000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty