Organization
OLD PUEBLO UROLOGY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARLA BROWN (ADMINISTRATION)
(520) 623-8475
Entity
Organization
Contact information
Practice address
445 N SILVERBELL RD, 201, TUCSON, AZ 85745-2685
(520) 623-8475
Mailing address
445 N SILVERBELL RD, 201, TUCSON, AZ 85745-2685
(520) 623-8475
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
925159
—
AZ
01
—
CD3087
RAILROAD MEDICARE
AZ
Enumeration date
07/08/2006
Last updated
07/21/2022
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