Provider Demographics
NPI:1568751790
Name:RAUDALES, RAUL A JR (MD)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:A
Last Name:RAUDALES
Suffix:JR
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 31630
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1630
Mailing Address - Country:US
Mailing Address - Phone:520-784-6200
Mailing Address - Fax:520-784-6109
Practice Address - Street 1:6320 N LA CHOLLA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3549
Practice Address - Country:US
Practice Address - Phone:520-382-8200
Practice Address - Fax:520-297-3505
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.124202207QS0010X
AZ74060207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine