David a Pedersen MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

23255 Issued in AZ

Legal business name

DAVID A PEDERSEN MD PC

Practice address

1712 W Anklam Rd Ste 103
Tucson, AZ 85745-2660

Phone

(520) 622-7384

Fax

(520) 622-4899

NPI assigned

Jul 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David Andrew Pedersen, MD

Title

Owner

Phone

(520) 622-7384

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1669672747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 W ANKLAM RD STE 103",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452660",
            "telephone_number": "520-622-7384",
            "fax_number": "520-622-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 W ANKLAM RD STE 103",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452660",
            "telephone_number": "520-622-7384",
            "fax_number": "520-622-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A PEDERSEN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-622-7384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "23255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deron Michael Davenport, D.D.S.
• James Lee Davenport II, DDS
• Karen Davenport, MD
• Laconda Davenport, FNP
• Philip Christopher Davia, PA
• David a. Tetrault, OD, PC
• David D Heaton LLC
• David Engelsberg MD PC
• David Gooden LCSW PC
• David J Martin MD PC

• Specialist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.