MEDICARE: ARIZONA HEART INSTITUTE LTD PAYSON

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RC0000X	Cardiovascular Disease Physician
2	2086S0129X	Vascular Surgery Physician
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
4	208600000X	Surgery Physician

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

General Provider Information

NPI Number	:	1508041237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA HEART INSTITUTE LTD PAYSON

Provider Business Mailing Address
First Line	:	PO BOX 61773
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85082-1773
Country	:	US
Telephone Number	:	602-240-5887
Fax Number	:	602-240-6177

Provider Business Practice Location Address
First Line	:	708 COEUR D'ALENE
Second Line	:	SUITE B
City	:	PAYSON
State	:	AZ
Zip	:	85541-5662
Country	:	US
Telephone Number	:	602-266-2200
Fax Number	:	602-240-6177

Authorized Official
Title or Position	:	BUSINESS OFFICE DIRECTOR
Name	:	CATHY MAURER
Credential	:
Telephone Number	:	602-682-6703

Provider Enumeration Date	:	12/31/2007
Last Update Date	:	06/21/2018

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Directions to “ARIZONA HEART INSTITUTE LTD PAYSON ” Practice Location

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