Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 220526 | AZ |
N | 207RR0500X | Rheumatology | 220526 | AZ |
NPI | 1063984029 |
---|---|
Provider Name | Angelita Lynnette Poston |
First Address | Tucson, AZ 85711-3629 |
Second Address | Tucson, AZ 85715-4637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2018 |
Last Update Date | 08/09/2020 |