Agave Family Medicine

Organization Active NPI Family Medicine Physician · Tucson, AZ

NPI 1407809387 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1407809387
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
33407 (AZ)
Legal business name
AGAVE FAMILY MEDICINE
Practice address
8710 N Thornydale Rd
Ste 160
Tucson, AZ 85742-5031
Phone
(520) 744-2441
NPI assigned
May 19, 2006
Organization subpart
No

Authorized official

Name
Charles A Michieli, MD NPI 1205892841
Title
President
Phone
(520) 744-2441

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 33407 AZ Yes

Addresses

Primary practice location

8710 N Thornydale Rd
Ste 160
Tucson, AZ 85742-5031

Mailing address

PO Box 43100
Tucson, AZ 85733-3100
Phone (520) 722-3777

Other providers in Tucson, AZ

All providers in Tucson, AZ · Family Medicine Physician in Arizona

Sources for this page

Verify at the official NPI Registry.