Healthcare Provider Details

I. General information

NPI: 1952358723
Provider Name (Legal Business Name): SUN HEALTH PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 11/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 W THUNDERBIRD BLVD
SUN CITY AZ
85351-3004
US

IV. Provider business mailing address

PO BOX 1149
PEORIA AZ
85380-1149
US

V. Phone/Fax

Practice location:
  • Phone: 623-876-5351
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM T SELLNER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 623-876-6616