Basic Information
Provider Information
NPI: 1063850725
EntityType: 2
ReplacementNPI:  
OrganizationName: ARIZONA PHYSICIAN SPECIALISTS PC
LastName:  
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Mailing Information
Address1: 10632 N SCOTTSDALE RD
Address2: B-225
City: SCOTTSDALE
State: AZ
PostalCode: 852546164
CountryCode: US
TelephoneNumber: 6027957256
FaxNumber: 6027957257
Practice Location
Address1: 5620 W THUNDERBIRD RD
Address2: STE B-3
City: GLENDALE
State: AZ
PostalCode: 853064636
CountryCode: US
TelephoneNumber: 6027957256
FaxNumber: 6027957257
Other Information
ProviderEnumerationDate: 06/04/2013
LastUpdateDate: 08/25/2016
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: JOU
AuthorizedOfficialFirstName: LIZ
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AuthorizedOfficialTitleorPosition: VICE PRESIDENT
AuthorizedOfficialTelephone: 6027957256
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000X  Y193200000X MULTI-SPECIALTY GROUPOther Service ProvidersSpecialist 

No ID Information.


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