Healthcare Provider Details

I. General information

NPI: 1679536676
Provider Name (Legal Business Name): STUART POSNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N 12TH ST #618
PHOENIX AZ
85006-2848
US

IV. Provider business mailing address

1300 N 12TH ST 618
PHOENIX AZ
85006-2848
US

V. Phone/Fax

Practice location:
  • Phone: 602-258-1231
  • Fax: 602-340-9607
Mailing address:
  • Phone: 602-258-1231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number9295
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: