Provider Demographics
NPI:1659877629
Name:SCOVILLE, STEVEN (MD, PHD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:SCOVILLE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BANNER - UNIVERSITY MEDICAL CENTER TUCSON
Mailing Address - Street 2:1625 N CAMPBELL AVE
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719
Mailing Address - Country:US
Mailing Address - Phone:520-694-5437
Mailing Address - Fax:
Practice Address - Street 1:BANNER - UNIVERSITY MEDICAL CENTER TUCSON
Practice Address - Street 2:1625 N CAMPBELL AVE
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719
Practice Address - Country:US
Practice Address - Phone:520-694-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-30
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ765662086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric SurgeryGroup - Single Specialty