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General NPI Number Information
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NPI Number | 1124712898
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Entity Type | Organization
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Legal Business Name | NORTHERN ARIZONA HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 1895 N JASPER DR STE 1
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1632
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Country | US
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Telephone | 928-213-6527
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 N BEAVER ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3118
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Country | US
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Telephone | 928-213-6527
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | ROBERT COFIELD
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Credential |
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Telephone | 773-773-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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