Healthcare Provider Details

I. General information

NPI: 1023912201
Provider Name (Legal Business Name): NATIONAL PROVIDER SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5227 N 7TH ST
PHOENIX AZ
85014-2802
US

IV. Provider business mailing address

5227 N 7TH ST STE 83272
PHOENIX AZ
85014-2802
US

V. Phone/Fax

Practice location:
  • Phone: 866-653-1880
  • Fax:
Mailing address:
  • Phone: 866-653-1880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHAEL J ZIZMOR
Title or Position: DIRECTOR
Credential: MD
Phone: 866-653-1880