1609845619 NPI number — ARIZONA INSTITUTE FOR GENETICS AND FETAL MEDICINE, A PROFESSIONAL CORP

Table of content: (NPI 1609845619)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609845619 NPI number — ARIZONA INSTITUTE FOR GENETICS AND FETAL MEDICINE, A PROFESSIONAL CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARIZONA INSTITUTE FOR GENETICS AND FETAL MEDICINE, A PROFESSIONAL CORP
Provider Last Name:
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Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1609845619
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6301 S MCCLINTOCK DR
Provider Second Line Business Mailing Address:
SUITE 115
Provider Business Mailing Address City Name:
TEMPE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85283-3392
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-897-0234
Provider Business Mailing Address Fax Number:
480-897-0647

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6301 S MCCLINTOCK DR
Provider Second Line Business Practice Location Address:
SUITE 115
Provider Business Practice Location Address City Name:
TEMPE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85283-3392
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-897-0234
Provider Business Practice Location Address Fax Number:
480-897-0647
Provider Enumeration Date:
03/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SIMPSON
Authorized Official First Name:
GARY
Authorized Official Middle Name:
F
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
480-897-0234

Provider Taxonomy Codes

  • Taxonomy code: 207SG0201X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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