Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 6192 | AZ |
NPI | 1861592826 |
---|---|
Provider Name | Dr. Gail N Shultz |
First Address | Tucson, AZ 85704-4141 |
Second Address | Tucson, AZ 85745-9348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
221862 | (05) | AZ |