Madera Medical Center, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

2224 Issued in AZ

Legal business name

MADERA MEDICAL CENTER, PC

Practice address

100 E Ajo Way
Tucson, AZ 85713-6105

Phone

(520) 889-8879

Fax

(520) 294-2911

NPI assigned

Feb 15, 2012

Organization subpart

No

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

Authorized official

Name

Gerald B Roth, D.O.

Title

President

Phone

(520) 889-8879

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371600000000",
    "number": "1841563244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E AJO WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857136105",
            "telephone_number": "520-889-8879",
            "fax_number": "520-294-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E AJO WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857136105",
            "telephone_number": "520-889-8879",
            "fax_number": "520-294-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADERA MEDICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2013-06-19",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-889-8879",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "2224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William A Madden, MD
• Gerard Joseph Maddock, MED
• Marlaina Maddux
• Jacqueline Joanne Madeline, BA, RBT
• Madera Counseling Center
• Joshikha Madhav
• Devanshi Madhvani, OTD
• Chantal Madiata
• Siraelle Madiata
• Brian Kevin Madigan, M.D.

• Primary Care Clinic/Center in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.