Healthcare Provider Details

I. General information

NPI: 1467759092
Provider Name (Legal Business Name): ARIZONA PHYSICIAN CONSULTANTS PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 04/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 W 24TH ST
YUMA AZ
85364-6373
US

IV. Provider business mailing address

DEPT 5258
LOS ANGELES CA
90084-5258
US

V. Phone/Fax

Practice location:
  • Phone: 928-726-6335
  • Fax: 928-726-6501
Mailing address:
  • Phone: 330-470-3700
  • Fax: 330-470-3753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: KURT J. EHLERT
Title or Position: OWNER
Credential: MD
Phone: 928-726-6335