Healthcare Provider Details

I. General information

NPI: 1881928760
Provider Name (Legal Business Name): ROBERT W ENGLAND JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2009
Last Update Date: 09/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 E ROOSEVELT ST
PHOENIX AZ
85006-3638
US

IV. Provider business mailing address

4041 N CENTRAL AVE SUITE 1400
PHOENIX AZ
85012-3330
US

V. Phone/Fax

Practice location:
  • Phone: 602-506-6657
  • Fax: 602-372-0342
Mailing address:
  • Phone: 602-506-6601
  • Fax: 602-372-0342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number16377
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: