MEDICARE: HONORHEALTH AMBULATORY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363AS0400X	Surgical Physician Assistant
2	363LF0000X	Family Nurse Practitioner
3	208600000X	Surgery Physician
4	2086X0206X	Surgical Oncology Physician

General Provider Information

NPI Number	:	1841921301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HONORHEALTH AMBULATORY

Provider Business Mailing Address
First Line	:	2500 W UTOPIA RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85027-4171
Country	:	US
Telephone Number	:	480-882-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9250 N 3RD ST STE 2035
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2407
Country	:	US
Telephone Number	:	623-246-5662
Fax Number	:

Authorized Official
Title or Position	:	EVP/CPE
Name	:	JOHN NEIL
Credential	:
Telephone Number	:	480-587-5123

Provider Enumeration Date	:	06/23/2022
Last Update Date	:	06/23/2022

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Directions to “HONORHEALTH AMBULATORY ” Practice Location

Language	Start Address	Practice Location

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