Healthcare Provider Details

I. General information

NPI: 1497143895
Provider Name (Legal Business Name): ARIZONA ONCOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2015
Last Update Date: 08/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10460 N 92ND ST STE. # 402
SCOTTSDALE AZ
85258-4548
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 480-860-2540
  • Fax: 480-657-3274
Mailing address:
  • Phone: 520-519-7775
  • Fax: 520-519-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: TEENA BLAKLEY
Title or Position: SR. ADINISTRATIVE ASSISTANT
Credential:
Phone: 623-487-3723