Individual
IRIS BACCAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5100 E BROADWAY BLVD, TUCSON, AZ 85711-3762
(520) 613-3001
Mailing address
5100 E BROADWAY BLVD, TUCSON, AZ 85711-3762
(520) 613-3001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2025003070
MO
207Q00000X
Family Medicine Physician
Primary
67162
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2019
Last updated
02/12/2025
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