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NPI Code Detail

MEDICARE: CLINICAL PARTNERS PA ARIZONA

MEDICARE: CLINICAL PARTNERS PA ARIZONA
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
1207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1861425167
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINICAL PARTNERS PA ARIZONA
Provider Business Mailing Address
First Line : PO BOX 5188
Second Line :
City : LONGVIEW
State : TX
Zip : 75608-5188
Country : US
Telephone Number : 903-663-3600
Fax Number :
Provider Business Practice Location Address
First Line : 1800 E VAN BUREN ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-3742
Country : US
Telephone Number : 903-663-3600
Fax Number :
Authorized Official
Title or Position : OWNER
Name : HAROLD LEE BOLNICK
Credential : M.D.
Telephone Number : 903-663-3600
Provider Enumeration Date : 07/09/2006
Last Update Date : 08/22/2020

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Directions to “CLINICAL PARTNERS PA ARIZONA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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