| Oro Valley Adult Medicine Pa Llc | |
|
555 E Vuelta Caminata Del Rio Oro Valley AZ 85737 | |
| (520) 547-5688 | |
| (520) 547-4661 |
| Full Name | Oro Valley Adult Medicine Pa Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 555 E Vuelta Caminata Del Rio, Oro Valley, Arizona |
| Authorized Official Name and Position | Eun J Oh (PHYSICIAN) |
| Authorized Official Contact | 5203106758 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oro Valley Adult Medicine Pa Llc 555 E Vuelta Caminata Del Rio Oro Valley AZ 85737 Ph: (520) 547-5688 | Oro Valley Adult Medicine Pa Llc 555 E Vuelta Caminata Del Rio Oro Valley AZ 85737 Ph: (520) 547-5688 |
| NPI Number | 1679012181 |
|---|---|
| Provider Enumeration Date | 02/16/2017 |
| Last Update Date | 06/01/2018 |
| Medicare PECOS PAC ID | 3870861503 |
|---|---|
| Medicare Enrollment ID | O20170621000519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679012181 | NPI | - | NPPES |
| 1558391672 | Other | AZ | NPI |
| 1043252844 | Other | AZ | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 41024 (Arizona) | Primary |
| Provider Name | John D Dougherty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043252844 PECOS PAC ID: 1456354059 Enrollment ID: I20081113000355 |
| Provider Name | Eun J Oh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558391672 PECOS PAC ID: 7113020959 Enrollment ID: I20081126000529 |
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