Healthcare Provider Details

I. General information

NPI: 1457343303
Provider Name (Legal Business Name): ARIZONA CARDIOLOGY GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 11/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 E PALM LN SUITE 175
PHOENIX AZ
85004-4603
US

IV. Provider business mailing address

340 E PALM LN SUITE 175
PHOENIX AZ
85004-4603
US

V. Phone/Fax

Practice location:
  • Phone: 602-386-1100
  • Fax: 602-386-1150
Mailing address:
  • Phone: 602-386-1100
  • Fax: 602-386-1150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES HINES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 602-386-1100