Magnuson, Alise
Magnuson, Alise is an individual health care provider with primary practice located at 1103 Circulo Mercado , Nogales AZ 85648-6248. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Magnuson, Alise can be contacted via phone (520) 281-1550.Contact Information
Primary practice address
1103 Circulo Mercado
Nogales AZ 85648-6248
Phone: (520) 281-1550
Fax: (520) 281-1112
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0101233351 | Virginia |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 63116 | Arizona |
Profile Details
| NPI number | 1508864638 |
|---|---|
| LBN Legal business name | Magnuson, Alise |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2005 |
| Last updated | May 26th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508864638 | NPPES |
| Arizona | MEDICAID | 098235 |
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