Healthcare Provider Details

I. General information

NPI: 1487092094
Provider Name (Legal Business Name): ARIZONA ONCOLOGY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 08/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 E HIGHLAND AVE STE. # 400
PHOENIX AZ
85016-4872
US

IV. Provider business mailing address

2222 E HIGHLAND AVE STE. # 400
PHOENIX AZ
85016-4872
US

V. Phone/Fax

Practice location:
  • Phone: 602-277-4868
  • Fax: 602-230-9350
Mailing address:
  • Phone: 602-477-4868
  • Fax: 602-230-9350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number21011
License Number StateAZ

VIII. Authorized Official

Name: GERALD LUCAS
Title or Position: MD
Credential: MD
Phone: 602-283-2345