Medifast Tucson Com Incorporated

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

MEDIFAST TUCSON COM INCORPORATED

Practice address

5350 E Erickson Dr
Tucson, AZ 85712-2822

Phone

(520) 733-2250

Fax

(520) 733-2270

NPI assigned

Jan 20, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brad T Manny, MD

Title

President

Phone

(520) 733-2250

Specialties & licenses 1

Addresses

Other names 1

• Bard T. Manny, MD. Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453334400000",
    "number": "1073970133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14377",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857324377",
            "telephone_number": "520-733-2250",
            "fax_number": "520-733-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 E ERICKSON DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122822",
            "telephone_number": "520-733-2250",
            "fax_number": "520-733-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIFAST TUCSON COM INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-01-21",
        "status": "A",
        "authorized_official_last_name": "MANNY",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-733-2250",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bard T. Manny, MD.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medical Diagnostic Center Inc
• Medical Nutrition Therapy of Arizona LLC
• Medical Resource Imaging LLC
• Medical Services of Southern Arizona
• Medical Transportation Company of Tucson, LLC
• Jessica Angelica Medina
• Roberto Carlos Medina Jr., PTA
• John C Medlen, MD
• Sue M Medlen, NP
• Meggan Anne Medley, D.C., PMHNP

• Pain Medicine (Anesthesiology) Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Pain Medicine (Anesthesiology) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.