Healthcare Provider Details

I. General information

NPI: 1306424254
Provider Name (Legal Business Name): BRITTANY EWING DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W THOMAS RD
PHOENIX AZ
85013-4409
US

IV. Provider business mailing address

350 W THOMAS RD
PHOENIX AZ
85013-4409
US

V. Phone/Fax

Practice location:
  • Phone: 602-263-9007
  • Fax: 330-375-4874
Mailing address:
  • Phone: 602-263-9007
  • Fax: 330-375-4874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number012420
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number012420
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: