Provider Demographics
NPI:1407893423
Name:TITONE, JAMES M (PAC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:TITONE
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 E SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-1162
Mailing Address - Country:US
Mailing Address - Phone:520-618-1630
Mailing Address - Fax:520-618-1636
Practice Address - Street 1:1735 E SKYLINE DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-1162
Practice Address - Country:US
Practice Address - Phone:520-618-1630
Practice Address - Fax:520-618-1636
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3193363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AP2273Medicare UPIN