1306983739 NPI number — ARIZONA ONCOLOGY SERVICES SURGICENTER

Table of content: (NPI 1306983739)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306983739 NPI number — ARIZONA ONCOLOGY SERVICES SURGICENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARIZONA ONCOLOGY SERVICES SURGICENTER
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:
Provider Other Organization Name Type Code:
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:
1306983739
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 W CLARENDON AVE
Provider Second Line Business Mailing Address:
SUITE 350
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85013-3420
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-240-3395
Provider Business Mailing Address Fax Number:
602-240-3539

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 W CLARENDON AVE
Provider Second Line Business Practice Location Address:
SUITE 350
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85013-3420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-240-3395
Provider Business Practice Location Address Fax Number:
602-240-3539
Provider Enumeration Date:
02/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BEYER
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
C
Authorized Official Title or Position:
VICE PRESIDENT/ MEDICAL DIRECTOR
Authorized Official Telephone Number:
602-240-3395

Provider Taxonomy Codes

  • Taxonomy code: 261QX0203X , with the licence number:  03C0001222 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: Z30WCHJD08 . This is a "T CANTY" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z76179 . This is a "R KUSKE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z30WCHJD09 . This is a "E GRADE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z105955 . This is a "K LUK" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z29943 . This is a "L CHEN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z24460 . This is a "J KRESL" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z29510 . This is a "F YANG" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: ZWCHJD14 . This is a "D BRACHMAN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z105956 . This is a "G LUCAS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: Z109650 . This is a "H MITSUYAMA" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z115004 . This is a "L STEGMAN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z30WCHJD01 . This is a "G MAGGASS" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z109521 . This is a "J ASHMAN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z30WCHJD13 . This is a "C QUIET" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z76882 YUMA . This is a "T GALANG" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z80190 . This is a "T TAYLOR" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z20516 . This is a "D RECINE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z30WCHJD07 . This is a "D BEYER" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z64038 . This is a "I TAW" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z80188 . This is a "N FLORES" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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