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Individual

DR. OVETTE VILLAVICENCIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D, PH.D.

Contact information

Practice address
3925 E FORT LOWELL RD STE 100, TUCSON, AZ 85712-1053
(520) 576-5110
(520) 529-7165
Mailing address
3925 E FORT LOWELL RD STE 100, TUCSON, AZ 85712-1053
(520) 576-5110
(520) 529-7165

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01073604A
IN
207W00000X
Ophthalmology Physician
Primary
50246
AZ
390200000X
Student in an Organized Health Care Education/Training Program
R72235
AZ

Other

Enumeration date
06/30/2010
Last updated
07/30/2020
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