Healthcare Provider Details

I. General information

NPI: 1972658482
Provider Name (Legal Business Name): JOHN RAUL ARES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 N CENTRAL AVE SUITE 1600
PHOENIX AZ
85004
US

IV. Provider business mailing address

1850 N CENTRAL AVE SUITE 1600
PHOENIX AZ
85004
US

V. Phone/Fax

Practice location:
  • Phone: 602-262-8900
  • Fax: 602-262-8890
Mailing address:
  • Phone: 602-262-8900
  • Fax: 602-262-8890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberAZ30822
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number12686
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: