Healthcare Provider Details
I. General information
NPI: 1841861143
Provider Name (Legal Business Name): HONORHEALTH AMBULATORY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2021
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3645 S ROME ST STE 204
GILBERT AZ
85297-7338
US
IV. Provider business mailing address
2500 W UTOPIA RD
PHOENIX AZ
85027-4171
US
V. Phone/Fax
- Phone: 480-534-4520
- Fax:
- Phone: 480-587-5314
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086X0206X |
| Taxonomy | Surgical Oncology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
NEIL
Title or Position: SVP/CPE
Credential:
Phone: 480-587-5123