Healthcare Provider Details

I. General information

NPI: 1750094983
Provider Name (Legal Business Name): REPRODUCTIVE CHOICE AZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 N 7TH ST STE 225
PHOENIX AZ
85006-2768
US

IV. Provider business mailing address

1331 N 7TH ST STE 225
PHOENIX AZ
85006-2768
US

V. Phone/Fax

Practice location:
  • Phone: 602-553-0440
  • Fax: 602-462-5588
Mailing address:
  • Phone: 602-553-0440
  • Fax: 602-462-5588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. TONYA IRICK
Title or Position: CLINIC DIRECTOR
Credential:
Phone: 602-553-0440