Individual
MARCUS JOHN DILL-MACKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
677 N WILMOT RD, TUCSON, AZ 85711-2701
(520) 795-2889
(520) 795-6321
Mailing address
677 N WILMOT RD, TUCSON, AZ 85711-2701
(520) 795-2889
(520) 795-6321
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
36072
AZ
2085U0001X
Diagnostic Ultrasound Physician
36072
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005472
GROUP MEDICAID ID
AZ
05
—
178062
—
AZ
01
—
1841261989
GROUP NPI
AZ
01
—
1992842603
PHYSICIAN INDIVIDUAL NPI NUMBER
AZ
01
—
CS7943
GROUP MEDICARE RAILROAD ID & PTAN
AZ
01
—
P00406247
MEDICARE RAILROAD
AZ
01
—
ZWCBBM
GROUP MEDICARE ID
AZ
Enumeration date
01/31/2007
Last updated
02/27/2013
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