Healthcare Provider Details

I. General information

NPI: 1801985486
Provider Name (Legal Business Name): THE PHOENIX CHILDREN'S CENTER, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 E CAMELBACK RD STE 170
PHOENIX AZ
85016-3921
US

IV. Provider business mailing address

1661 E CAMELBACK RD STE 170
PHOENIX AZ
85016-3921
US

V. Phone/Fax

Practice location:
  • Phone: 602-263-9550
  • Fax: 602-274-1552
Mailing address:
  • Phone: 602-263-9550
  • Fax: 602-274-1552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BARBARA ANNE LEDNICKY
Title or Position: OFFICER
Credential: M.D.
Phone: 602-263-9550