Organization
BREAST CENTER OF SOUTHERN ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC B WHITACRE MD (PRESIDENT)
(520) 319-6686
Entity
Organization
Contact information
Practice address
5230 E FARNESS DR, SUITE 104, TUCSON, AZ 85712-2141
(520) 319-6686
(520) 319-6696
Mailing address
PO BOX 43130, TUCSON, AZ 85733-3130
(520) 722-3777
(520) 296-6224
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
32120
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
829426
—
AZ
Enumeration date
09/22/2006
Last updated
08/22/2020
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