Healthcare Provider Details

I. General information

NPI: 1740294420
Provider Name (Legal Business Name): ENDOCRINOLOGY ASSOCIATES P A DTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9328 E RAINTREE DR
SCOTTSDALE AZ
85260-2098
US

IV. Provider business mailing address

9328 E RAINTREE DR
SCOTTSDALE AZ
85260-2098
US

V. Phone/Fax

Practice location:
  • Phone: 602-266-8463
  • Fax: 602-266-0122
Mailing address:
  • Phone: 602-266-8463
  • Fax: 602-266-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: KELLY HOWELL
Title or Position: FRONT OFFICE MANAGER
Credential:
Phone: 602-266-8463