Healthcare Provider Details
I. General information
NPI: 1972628675
Provider Name (Legal Business Name): ARIZONA ONCOLOGY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2007
Last Update Date: 03/09/2011
Certification Date:
Deactivation Date: 02/23/2011
Reactivation Date: 03/09/2011
III. Provider practice location address
300 W CLARENDON SUITE 350
PHOENIX AZ
85013
US
IV. Provider business mailing address
300 W CLARENDON SUITE 350
PHOENIX AZ
85013
US
V. Phone/Fax
- Phone: 602-274-4484
- Fax: 602-287-9406
- Phone: 602-274-4484
- Fax: 602-287-9406
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | 11736 |
| License Number State | AZ |
VIII. Authorized Official
Name:
BURTON
L
SPEISER
Title or Position: PRESIDENT
Credential: MD
Phone: 602-240-3468