Healthcare Provider Details

I. General information

NPI: 1275739971
Provider Name (Legal Business Name): ASSOCIATED FAMILY PHYSICIANS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4840 E INDIAN SCHOOL RD SUITE 100
PHOENIX AZ
85018-5500
US

IV. Provider business mailing address

4840 E INDIAN SCHOOL RD SUITE 100
PHOENIX AZ
85018-5500
US

V. Phone/Fax

Practice location:
  • Phone: 602-508-2920
  • Fax: 602-952-9432
Mailing address:
  • Phone: 602-508-2920
  • Fax: 602-952-9432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13881
License Number StateAZ

VIII. Authorized Official

Name: RONALD W VARNS
Title or Position: VICE-PRESIDENT, TREASURER
Credential: M.D.
Phone: 602-508-2920