Healthcare Provider Details

I. General information

NPI: 1417345919
Provider Name (Legal Business Name): ARIZONA ONCOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2015
Last Update Date: 01/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19646 N 27TH AVE STE. # 406
PHOENIX AZ
85027-4028
US

IV. Provider business mailing address

1760 E RIVER RD STE. # 350
TUCSON AZ
85718-5877
US

V. Phone/Fax

Practice location:
  • Phone: 623-587-4868
  • Fax: 623-582-9767
Mailing address:
  • Phone: 520-519-7775
  • Fax: 520-519-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: LINDA WALKER
Title or Position: CREDENTIALIST
Credential:
Phone: 520-519-7775