Basic Information
| Provider Information | |||||||||
| NPI: | 1114140738 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARIZONA CARDIOVASCULAR SPECIALISTS, P.C. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | THE HEART CENTER OF SOUTHERN ARIZONA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1601 N SWAN RD | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857124046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206151023 | ||||||||
| FaxNumber: | 5205462934 | ||||||||
| Practice Location | |||||||||
| Address1: | 1601 N SWAN RD | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857124046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206151023 | ||||||||
| FaxNumber: | 5205462934 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2007 | ||||||||
| LastUpdateDate: | 05/19/2010 | ||||||||
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| AuthorizedOfficialLastName: | DAVIS | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5205462420 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.