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General NPI Number Information
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NPI Number | 1316961022
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Entity Type | Organization
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Legal Business Name | OBSTETRIX MEDICAL GROUP OF ARIZONA, P.C.
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 03/01/2016
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Provider Practice Location Address
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Address Line | 5301 E GRANT RD STE 150
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City | TUCSON
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State | AZ
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Zip | 85712-2805
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Country | US
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Telephone | 520-795-8188
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Fax | 520-325-0809
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Provider Business Mailing Address
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Address Line | 4722 N 24TH ST STE. 150
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City | PHOENIX
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State | AZ
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Zip | 85016-4800
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Country | US
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Telephone | 602-256-4628
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Fax | 855-851-4319
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Authorized Official
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Title or Position | DIRECTOR / PRESIDENT
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Name | KEITH S. MEREDITH
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Credential | MD
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Telephone | 602-256-4628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology 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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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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 | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number |
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License Number State |
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