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General NPI Number Information
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NPI Number | 1407255201
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Entity Type | Organization
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Legal Business Name | SOUTHWEST PATHOLOGY PLLC
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 08/18/2014
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Provider Practice Location Address
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Address Line | 6101 S RURAL RD STE 102
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City | TEMPE
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State | AZ
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Zip | 85283-2910
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Country | US
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Telephone | 480-878-5224
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Fax | 480-427-3922
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Provider Business Mailing Address
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Address Line | 6101 S RURAL RD STE 102
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City | TEMPE
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State | AZ
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Zip | 85283-2910
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Country | US
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Telephone | 480-878-5224
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Fax | 480-427-3922
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Authorized Official
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Title or Position | DIRECTOR
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Name | PUJA VERMA
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Credential | MD
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Telephone | 480-878-5224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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