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TINA AUDIE M.D.
>> Pediatrics >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1477947679
Individual Registrant: TINA AUDIE M.D.
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
13395 N MARANA MAIN ST MARANA, AZ 85653-7008 US
Tel: 520-682-4111 Fax: 520-682-3817
Tel: 520-682-4111 Fax: 520-682-3817
Contact information for business:
PO BOX 188 MARANA, AZ 85653-0188 US
Tel: 520-682-4111 Fax: 520-818-3630
Tel: 520-682-4111 Fax: 520-818-3630
Registration Information:
NPI: 1477947679
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 208000000X | Allopathic & Osteopathic Physicians Pediatrics | NM | RS2015-0281 |
| Y | 208000000X | Allopathic & Osteopathic Physicians Pediatrics | AZ | 56172 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
