| Dr Alise Magnuson, MD | |
|
1103 Circulo Mercado, Nogales, AZ 85648-6248 | |
| (520) 281-1550 | |
| (520) 281-1112 |
| Full Name | Dr Alise Magnuson |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1103 Circulo Mercado, Nogales, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508864638 | NPI | - | NPPES |
| 098235 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 0101233351 (Virginia) | Secondary |
| 208000000X | Pediatrics | 63116 (Arizona) | Primary |
| Entity Name | Maricopa County Special Health Care District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073576740 PECOS PAC ID: 4688583651 Enrollment ID: O20031204000823 |
| Entity Name | District Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336472448 PECOS PAC ID: 7315086691 Enrollment ID: O20091125000583 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Alise Magnuson, MD 825 N Grand Ave Ste 100, Nogales, AZ 85621-1061 Ph: (520) 281-1550 | Dr Alise Magnuson, MD 1103 Circulo Mercado, Nogales, AZ 85648-6248 Ph: (520) 281-1550 |
Tanya Henry, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1852 N Mastick Way, Nogales, AZ 85621 Phone: 520-281-1550 | |
Dr. Guadalupe Ibanez Davila, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1852 N Mastick Way, Nogales, AZ 85621 Phone: 520-281-1550 Fax: 520-281-4487 | |
Andrea Batshon, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1852 N Mastick Way, Nogales, AZ 85621 Phone: 520-281-1550 Fax: 520-281-1112 | |
Alfonso C. Robles, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1852 N Mastick Way, Nogales, AZ 85621 Phone: 520-281-1550 Fax: 520-281-4487 | |
Burt A Stanga, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1852 N Mastick Way, Nogales, AZ 85621 Phone: 520-375-6007 | |
Dr. Jeminah L. Van Handel, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1852 N Mastick Way, Nogales, AZ 85621 Phone: 520-281-1550 Fax: 520-281-2335 | |
Gonzalo E Ibarra Murrieta, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1852 N Mastick Way, Nogales, AZ 85621 Phone: 520-281-1550 Fax: 520-281-2335 |