Basic Information
| Provider Information | |||||||||
| NPI: | 1215380258 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ARIZONA OBGYN AFFILIATES, P.C. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1661 E CAMELBACK RD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850163911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022411671 | ||||||||
| FaxNumber: | 6022307982 | ||||||||
| Practice Location | |||||||||
| Address1: | 1661 E CAMELBACK RD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850163911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022411671 | ||||||||
| FaxNumber: | 6022307982 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2016 | ||||||||
| LastUpdateDate: | 07/14/2016 | ||||||||
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| AuthorizedOfficialLastName: | PLATZMAN | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 6022411671 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.