Basic Information
| Provider Information | |||||||||
| NPI: | 1396769972 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EMERGENCY PHYSICIAN PROFESSIONAL ASSOCIATION, LTD. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 40850 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852740850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808393313 | ||||||||
| FaxNumber: | 4808394182 | ||||||||
| Practice Location | |||||||||
| Address1: | 18701 N 67TH AVE | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853087100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808393313 | ||||||||
| FaxNumber: | 4808394182 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 07/26/2007 | ||||||||
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| AuthorizedOfficialLastName: | SCHWARTZ | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6028668472 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.