| NPI | 1598153843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEENA BLAKLEY Sr. Administrative Assistant 623-487-3723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: AZ 52718) |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: AZ 40789) | |
| 2085R0001X (Licence: AZ 42880) | |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2017-05-09 |