Organization
UNIVERSITY PHYSICIANS HEALTHCARE
Active
Other names
Kino Physicians Group
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA CASARES (CREDENTIALING LIAISON)
(520) 874-4135
Entity
Organization
Contact information
Practice address
2800 E AJO WAY, TUCSON, AZ 85713-6204
(520) 874-3500
(520) 874-7048
Mailing address
2701 E ELVIRA RD, TUCSON, AZ 85756-7124
(520) 874-4135
(520) 874-7048
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
BHH-2436
AZ
103TP0016X
Prescribing (Medical) Psychologist
BHH-2436
AZ
104100000X
Social Worker
BHH-2436
AZ
1041C0700X
Clinical Social Worker
BHH-2436
AZ
2084N0400X
Neurology Physician
BHH-2436
AZ
2084P0800X
Psychiatry Physician
Primary
BHH-2436
AZ
2084P0804X
Child & Adolescent Psychiatry Physician
BHH-2436
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28426827
OTHER
AZ
05
—
863771
—
AZ
01
—
DC6028
RR MEDICARE
AZ
Enumeration date
04/03/2006
Last updated
03/07/2023
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