Provider Demographics
NPI:1215791728
Name:HARGROVE, DEVON N
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:N
Last Name:HARGROVE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5852 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-6708
Mailing Address - Country:US
Mailing Address - Phone:520-370-6365
Mailing Address - Fax:
Practice Address - Street 1:5852 E 31ST ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-6708
Practice Address - Country:US
Practice Address - Phone:520-370-6365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle