Paul R Vanatta, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

15955 Issued in AZ

Practice address

6200 N la Cholla Blvd
Tucson, AZ 85741-3529

Phone

(520) 297-7826

Fax

(520) 544-0060

NPI assigned

Oct 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1629068051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 N LA CHOLLA BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413529",
            "telephone_number": "520-297-7826",
            "fax_number": "520-544-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANATTA",
        "first_name": "PAUL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "15955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263111",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0260290",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colin John Van Wagoner, MD
• Karen Lynne Van Wie, RN MS, PSY-MH NP
• Claire Van Zyl
• Saroja Vanacharla, M.D
• Matthew Edward Vanasco, MD
• Judith A Vance, FNP
• Katherine Therese Vance, PH.D.
• Misty Vancleaf
• Carrie Ann Vancuran, N.P.
• Sally Joan Vande Berg

• Anatomic Pathology & Clinical Pathology Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Anatomic Pathology & Clinical Pathology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.