Provider Demographics
NPI:1124099940
Name:RIOS, JOSE (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:RIOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 W IRVINGTON RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85714-3054
Mailing Address - Country:US
Mailing Address - Phone:520-884-7304
Mailing Address - Fax:520-623-0992
Practice Address - Street 1:225 W IRVINGTON RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-3054
Practice Address - Country:US
Practice Address - Phone:520-884-7304
Practice Address - Fax:520-623-0992
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21070207V00000X
AZ21079207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ138950Medicaid
AZ21079OtherAZ MEDICAL BOARD
AZFQ31801ALMedicare ID - Type Unspecified