Healthcare Provider Details

I. General information

NPI: 1235759630
Provider Name (Legal Business Name): ARIZONA PRECISION MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2020
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 N 1ST ST STE 700
PHOENIX AZ
85004-2364
US

IV. Provider business mailing address

1 N 1ST ST STE 700
PHOENIX AZ
85004-2364
US

V. Phone/Fax

Practice location:
  • Phone: 602-481-9650
  • Fax:
Mailing address:
  • Phone: 602-481-9650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0007X
TaxonomyMolecular Genetic Pathology (Pathology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA ROUTH
Title or Position: PHYSICIAN
Credential: MD
Phone: 602-481-9650