| NPI | 1659467397 |
|---|---|
| Doing Business As | ARIZONA DERMATOLOGY GROUP |
| Entity Type | Organization |
| Authorized Contact | AMY FAJARDO Billing/Credentialing 928-777-5807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 29683) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: AZ 29683) | |
| 207ND0900X Dermatology, Dermatopathology (Licence: AZ 29683) | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: AZ 29683) | |
| 208200000X Plastic Surgery (Licence: AZ 48829) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2019-04-11 |