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General NPI Number Information
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NPI Number | 1528200672
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Entity Type | Organization
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Legal Business Name | CIGNA HEALTH CARE OF ARIZONA, INC.
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Dates
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Enumeration Date | 04/02/2009
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Last Update Date | 01/09/2012
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Provider Practice Location Address
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Address Line | 39510 N DAISY MOUNTAIN DR SUITE 166
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City | ANTHEM
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State | AZ
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Zip | 85086-6059
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Country | US
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Telephone | 623-551-2311
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Fax | 623-551-4716
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Provider Business Mailing Address
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Address Line | 25500 N NORTERRA DR
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City | PHOENIX
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State | AZ
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Zip | 85085-8200
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Country | US
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Telephone | 602-328-8400
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Fax | 623-277-2335
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | JAMES H. BURRELL III
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Credential | M.D.
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Telephone | 602-271-5426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | PENDING
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License Number State | AZ
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