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NPI Code Detail

MEDICARE: ARLIE W. HEDRICK DO

MEDICARE: ARLIE W. HEDRICK DO
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
12085R0001XRadiation Oncology Physician4081AZ
2207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician4081AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1864505OTHERAZAHCCCS

General Provider Information

NPI Number : 1982699047
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARLIE W. HEDRICK DO
Provider Business Mailing Address
First Line : 3030 N CENTRAL AVE STE 1001
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2716
Country : US
Telephone Number : 602-406-4786
Fax Number : 916-636-4358
Provider Business Practice Location Address
First Line : 1955 W FRYE RD
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-6282
Country : US
Telephone Number : 480-728-3895
Fax Number : 480-728-3610
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2005
Last Update Date : 07/23/2019

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