MEDICARE: DR. VINCENT J HONAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	19895	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	120390	OTHER	AZ	MEDICARE GROUP NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073585014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT J HONAN MD

Provider Business Mailing Address
First Line	:	5343 E PALOMINO RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-1911
Country	:	US
Telephone Number	:	602-677-2798
Fax Number	:	928-773-2548

Provider Business Practice Location Address
First Line	:	77 W FOREST AVE STE 210
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-1481
Country	:	US
Telephone Number	:	928-773-2547
Fax Number	:	928-773-2548

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	08/29/2024

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Directions to “ DR. VINCENT J HONAN MD” Practice Location

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