Healthcare Provider Details

I. General information

NPI: 1174592091
Provider Name (Legal Business Name): ARIZONA PERINATAL PROVIDERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 S MCCLINTOCK DR SUITE 115
TEMPE AZ
85283-3392
US

IV. Provider business mailing address

6301 S MCCLINTOCK DR SUITE 115
TEMPE AZ
85283-3392
US

V. Phone/Fax

Practice location:
  • Phone: 480-897-0242
  • Fax: 480-897-0244
Mailing address:
  • Phone: 480-897-0242
  • Fax: 480-897-0244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: GARY F SIMPSON
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 480-897-0242