Healthcare Provider Details
I. General information
NPI: 1316764830
Provider Name (Legal Business Name): HONORHEALTH AMBULATORY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2024
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2181 E PECOS RD STE 1
CHANDLER AZ
85225-6140
US
IV. Provider business mailing address
2500 W UTOPIA RD STE 100
PHOENIX AZ
85027-4172
US
V. Phone/Fax
- Phone: 480-844-4702
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
NEIL
Title or Position: CMO
Credential:
Phone: 480-587-5052