Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 35889 | AZ |
NPI | 1124036371 |
---|---|
Provider Name | Mr. Augusto C Posadas JR. |
First Address | Tucson, AZ 85711 |
Second Address | Tucson, AZ 85715-4637 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 13/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
122500 | (05) | AZ |
Z145735 | PTAN (01) | AZ |