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NPI Code Detail

MEDICARE: DR. CORDELL A ESPLIN M.D.09

MEDICARE: DR. CORDELL A ESPLIN M.D.09
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician15333AZ
22085R0204XVascular & Interventional Radiology Physician15333AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11Z7077OTHERAZHEALTH NET OF AZ
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619942216
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CORDELL A ESPLIN M.D.09
Provider Business Mailing Address
First Line : PO BOX 27340
Second Line :
City : PHOENIX
State : AZ
Zip : 85061-7340
Country : US
Telephone Number : 602-943-9200
Fax Number : 602-216-3000
Provider Business Practice Location Address
First Line : 1800 E VAN BUREN ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-3742
Country : US
Telephone Number : 602-254-2123
Fax Number : 602-254-4172
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2006
Last Update Date : 05/19/2008

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