Healthcare Provider Details

I. General information

NPI: 1124699434
Provider Name (Legal Business Name): HONORHEALTH AMBULATORY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 E MOUNTAIN VIEW RD STE 120
SCOTTSDALE AZ
85258-5140
US

IV. Provider business mailing address

2500 W UTOPIA RD
PHOENIX AZ
85027-4171
US

V. Phone/Fax

Practice location:
  • Phone: 480-882-7510
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN NEIL
Title or Position: SVP/CPE
Credential:
Phone: 480-587-5123