| Banner-university Medical Group | |
|
535 N Wilmot Rd Fl 2 Tucson AZ 85711-2600 | |
| (520) 694-1234 | |
| Not Available |
| Full Name | Banner-university Medical Group |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 535 N Wilmot Rd Fl 2, Tucson, Arizona |
| Authorized Official Name and Position | Venkata Evani (CEO) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner-university Medical Group 2901 N Central Ave Phoenix AZ 85012-2700 Ph: () - | Banner-university Medical Group 535 N Wilmot Rd Fl 2 Tucson AZ 85711-2600 Ph: (520) 694-1234 |
| NPI Number | 1568818649 |
|---|---|
| Provider Enumeration Date | 05/09/2016 |
| Last Update Date | 11/15/2024 |
| Certification Date | 11/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568818649 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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