Healthcare Provider Details
I. General information
NPI: 1588927990
Provider Name (Legal Business Name): DHP OF ARIZONA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/20/2012
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2400 S AVENUE A
YUMA AZ
85364-7127
US
IV. Provider business mailing address
265 BROOKVIEW CENTRE WAY SUITE 400
KNOXVILLE TN
37919-4052
US
V. Phone/Fax
- Phone: 928-344-2000
- Fax:
- Phone: 865-693-1000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TOMMY
CHRIS
PRICE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 865-693-1000