Healthcare Provider Details

I. General information

NPI: 1598153843
Provider Name (Legal Business Name): ARIZONA ONCOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7695 S RESEARCH DR
TEMPE AZ
85284-1812
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 480-256-1664
  • Fax: 480-726-1854
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 Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number40789
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number42880
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number52718
License Number StateAZ

VIII. Authorized Official

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