Provider Demographics
NPI:1992751010
Name:STEPHEN K. LIAO M.D. PC
Entity type:Organization
Organization Name:STEPHEN K. LIAO M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:LIAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-544-5178
Mailing Address - Street 1:6241 N PLACITA DE LUIS
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-2736
Mailing Address - Country:US
Mailing Address - Phone:520-544-5178
Mailing Address - Fax:
Practice Address - Street 1:2181 W ORANGE GROVE RD
Practice Address - Street 2:#185
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3118
Practice Address - Country:US
Practice Address - Phone:520-575-5766
Practice Address - Fax:520-575-5593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24064207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty