Healthcare Provider Details
I. General information
NPI: 1215847645
Provider Name (Legal Business Name): PROFESSIONAL MEDICAL SERVICES OF ARIZONA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2600 N 44TH ST FL 1
PHOENIX AZ
85008-1521
US
IV. Provider business mailing address
304 WAINWRIGHT DR STE 120
NORTHBROOK IL
60062-1919
US
V. Phone/Fax
- Phone: 602-734-4405
- Fax:
- Phone: 847-257-1244
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
MORRISON
Title or Position: OWNER
Credential: MD
Phone: 727-644-3038