Individual
MARY RISVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2200 S HOUGHTON RD, TUCSON, AZ 85748-7632
(520) 543-6100
(659) 235-6176
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
37737
IA
207L00000X
Anesthesiology Physician
5124
AK
207L00000X
Anesthesiology Physician
Primary
84146
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5124
—
AK
Enumeration date
10/19/2006
Last updated
11/25/2024
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