Individual
MARTHA ANNE DEFORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1601 W SAINT MARYS RD, TUCSON, AZ 85745-2682
(520) 872-4901
Mailing address
8142 E 8TH ST, TUCSON, AZ 85710-2422
(520) 237-9299
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
3790
AZ
363A00000X
Physician Assistant
18506
CA
363A00000X
Physician Assistant
Primary
3790
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18506
STATE LICENCE
CA
Enumeration date
12/26/2006
Last updated
11/26/2025
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