Individual
MR. MICHAEL ROBERT MINCKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2800 E AJO WAY, TUCSON, AZ 85713-6204
(520) 874-2000
Mailing address
4834 E BROADWAY BLVD, TUCSON, AZ 85711-3610
(206) 551-0154
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R74121
AZ
207Q00000X
Family Medicine Physician
51123
AZ
208D00000X
General Practice Physician
Primary
51123
AZ
Other
Enumeration date
06/17/2013
Last updated
06/06/2024
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