1932133956 NPI number — PHOENIX GI ASSOCIATES PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932133956 NPI number — PHOENIX GI ASSOCIATES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHOENIX GI ASSOCIATES PC
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:
1932133956
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1040
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOLLESON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85353-1040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
623-907-8686
Provider Business Mailing Address Fax Number:
623-907-8440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9305 W THOMAS RD
Provider Second Line Business Practice Location Address:
SUITE 360
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85037-3328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-907-8686
Provider Business Practice Location Address Fax Number:
623-907-8440
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KHAN
Authorized Official First Name:
NADEEM
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
623-907-8686

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  34528 , 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)





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