Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 21070 | AZ |
Y | 207VX0000X | Obstetrician | 21079 | AZ |
NPI | 1124099940 |
---|---|
Provider Name | Jose Rios |
First Address | Tucson, AZ 85714-3054 |
Second Address | Tucson, AZ 85714-3054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 13/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
138950 | (05) | AZ |
21079 | AZ MEDICAL BOARD (01) | AZ |
F67341 | (02) | AZ |