Healthcare Provider Details

I. General information

NPI: 1013103043
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST, P.A. (AZ)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E JEFFERSON ST
PHOENIX AZ
85034-2219
US

IV. Provider business mailing address

5080 SPECTRUM DR SUITE 1200 WEST TOWER
ADDISON TX
75001-4648
US

V. Phone/Fax

Practice location:
  • Phone: 602-256-2281
  • Fax: 602-256-6199
Mailing address:
  • Phone: 800-232-3550
  • Fax: 800-401-6728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN ANDERSON
Title or Position: VP
Credential:
Phone: 972-364-8000