1255754131 NPI number — ARIZONA MEDICAL & INJURY PLLC

Table of content: (NPI 1255754131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255754131 NPI number — ARIZONA MEDICAL & INJURY PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARIZONA MEDICAL & INJURY PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
STAMP MEDICAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255754131
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/16/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ARIZONA MEDICAL & INJURY PLLC DBA STAMP MEDICAL
Provider Second Line Business Mailing Address:
3655 W ANTHEM WAY SUITE A109#272
Provider Business Mailing Address City Name:
ANTHEN
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85086
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
623-773-2000
Provider Business Mailing Address Fax Number:
877-599-5678

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ARIZONA MEDICAL & INJURY PLLC DBA STAMP MEDICAL
Provider Second Line Business Practice Location Address:
3201 W PEORIA AVE SUITE C500-A
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85029-4608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-773-2000
Provider Business Practice Location Address Fax Number:
877-599-5678
Provider Enumeration Date:
01/28/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LEON AGUILAR
Authorized Official First Name:
DELIA
Authorized Official Middle Name:
F
Authorized Official Title or Position:
BILLING LEAD
Authorized Official Telephone Number:
602-247-8630

Provider Taxonomy Codes

  • Taxonomy code: 163WA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207LP2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0014X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP3300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: AP5119 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: AP8585 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)