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Individual

MR. GILBERT JERRY FACIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSA

Contact information

Practice address
2424 N WYATT DR, TUCSON, AZ 85712-6115
(520) 784-6200
(520) 784-6167
Mailing address
313 E ROGER RD, TUCSON, AZ 85705-2829
(520) 887-5251
(520) 887-1421

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D31S3A
ARIZ.FOUNDATION MED. CAR
AZ
Enumeration date
09/15/2006
Last updated
07/08/2007
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