Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | AZ13843 | AZ |
Y | 208600000X | Surgeon | AZ13843 | AZ |
N | 2082S0105X | Plastic Hand Surgeon | AZ13843 | AZ |
N | 2086S0105X | Surgery of the Hand | AZ13843 | AZ |
N | 2086S0122X | Plastic and Reconstructive Surgery | AZ13843 | AZ |
NPI | 1467405084 |
---|---|
Provider Name | Dr. Armando J Alfaro JR. |
First Address | Tucson, AZ 85712 |
Second Address | Tucson, AZ 85712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 17/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
228933 | (05) | AZ |
D36490 | (02) | AZ |