Healthcare Provider Details

I. General information

NPI: 1184978934
Provider Name (Legal Business Name): CIGNA HEALTHCARE OF ARIZONA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2012
Last Update Date: 11/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 N 3RD ST
PHOENIX AZ
85012-3031
US

IV. Provider business mailing address

25500 N NORTERRA DR
PHOENIX AZ
85085-8200
US

V. Phone/Fax

Practice location:
  • Phone: 602-282-9800
  • Fax:
Mailing address:
  • Phone: 623-277-2335
  • Fax: 623-277-1203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateAZ

VIII. Authorized Official

Name: DR. JAMES H. BURRELL III
Title or Position: CHIEF MEDICAL OFFICER
Credential: M.D.
Phone: 623-277-1105