Healthcare Provider Details

I. General information

NPI: 1316336845
Provider Name (Legal Business Name): UNITED PHYSICIANS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 11/12/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20235 N CAVE CREEK RD STE 104, #622
PHOENIX AZ
85024-4455
US

IV. Provider business mailing address

13462 W JESSE RED DR
PEORIA AZ
85383-7904
US

V. Phone/Fax

Practice location:
  • Phone: 602-363-1116
  • Fax:
Mailing address:
  • Phone: 23-631-1166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number005591
License Number StateAZ

VIII. Authorized Official

Name: DR. JAMES D STEWART
Title or Position: PRESIDENT
Credential: D.O.
Phone: 602-363-1116