NPIMap

Organization Active NPI

Evan W Kligman M D P C

  • Geriatric Medicine (Family Medicine) Physician
  • Tucson, AZ
National Provider Identifier
1942346267
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
EVAN W KLIGMAN M D P C
Practice address
4635 E Fort Lowell Rd
Tucson, AZ 85712-1110
Phone
(520) 326-9355
Fax
(520) 795-1445
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Authorized official

Name
Evan W Kligman, MD
Title
Owner Provider
Phone
(520) 742-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X Primary

Addresses

Primary practice location

4635 E Fort Lowell Rd
Tucson, AZ 85712-1110

Mailing address

4635 E Fort Lowell Rd
Tucson, AZ 85712-1110
Phone (520) 326-9355

Other identifiers 4

IdentifierTypeStateIssuer
127585OtherAZHEALTHNET
AZ0841483OtherAZBCBS
D80158421OtherRAILROAD MEDICARE
207317MedicaidAZ

National Provider Directory

National Provider Directory

Locations

4635 E Fort Lowell Rd
Tucson, AZ 85712
Phone (520) 326-1457

2802 N Alvernon Way
Ste 200
Tucson, AZ 85712
Phone (520) 326-0850

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1942346267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4635 E FORT LOWELL RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121110",
            "telephone_number": "520-326-9355",
            "fax_number": "520-795-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4635 E FORT LOWELL RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121110",
            "telephone_number": "520-326-9355",
            "fax_number": "520-795-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVAN W KLIGMAN M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "KLIGMAN",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER PROVIDER",
        "authorized_official_telephone_number": "520-742-2200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "127585",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0841483",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "D80158421",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207317",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.