Healthcare Provider Details

I. General information

NPI: 1891809836
Provider Name (Legal Business Name): DESERT WEST OBSTETRICS & GYNECOLOGY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 W EUGIE AVE SUITE 100
GLENDALE AZ
85304-1255
US

IV. Provider business mailing address

5601 W EUGIE AVE SUITE 100
GLENDALE AZ
85304-1255
US

V. Phone/Fax

Practice location:
  • Phone: 602-978-1500
  • Fax: 602-978-0409
Mailing address:
  • Phone: 602-978-1500
  • Fax: 602-978-0409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateAZ

VIII. Authorized Official

Name: DR. ROBERT W PHILLIPS
Title or Position: PRESIDENT
Credential: MD
Phone: 602-978-1500