| Doctor Name: | DR. JOSEPH VIDZIUNAS |
| NPI Number: | 1578836177 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 7749 |
| Business Practice Address: | 5849 N Indian Trl Tucson, AZ - 857500894 |
| Business Phone Number: | 5202996384 |
| Business Fax Number: | |
| Mailing Address: | P.o. Box 30193, TUCSON |
| State: | AZ |
| Postal Code: | 857510193 |
| Phone Number: | 5202996384 |
| Fax Number: | |
| NPI Enumeration Date: | 02/14/2012 |
| NPI Last Update Date: | 03/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 7749 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |