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General NPI Number Information
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NPI Number | 1619083441
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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 | 08/22/2006
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 25500 N NORTERRA DR ATTN: HCFS (SUPPORT CENTER)
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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 |
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Provider Business Mailing Address
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Address Line | 25500 N NORTERRA DR ATTN: HCFS
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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 |
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Authorized Official
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Title or Position | CHIEF MEDICAL DIRECTOR
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Name | KEVIN ELLIS
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Credential | DO
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Telephone | 623-277-2246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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