Basic Information
| Provider Information | |||||||||
| NPI: | 1952875783 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VPA PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3420 E SHEA BLVD STE 200266 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850283345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809776000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7600 N 15TH ST STE 165B | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850204305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809776000 | ||||||||
| FaxNumber: | 2482690631 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2019 | ||||||||
| LastUpdateDate: | 12/31/2019 | ||||||||
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| AuthorizedOfficialLastName: | SASSER JR | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2488246600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 12/31/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 208D00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.