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General NPI Number Information
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NPI Number | 1881012144
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Entity Type | Organization
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Legal Business Name | ARIZONA HOSPITAL SPECIALISTS, PLLC
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Dates
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Enumeration Date | 04/03/2014
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Last Update Date | 04/03/2014
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Provider Practice Location Address
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Address Line | 10238 E HAMPTON AVE 205
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City | MESA
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State | AZ
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Zip | 85209-3316
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Country | US
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Telephone | 480-766-9479
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 830822
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City | RICHARDSON
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State | TX
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Zip | 75083-0822
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JAMAL OTULA
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Credential |
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Telephone | 214-364-0181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4446
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4446
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4446
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4446
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 4446
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License Number State | AZ
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