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NPI Code Detail

MEDICARE: ARIZONA PEDIATRICS,PLLC

MEDICARE: ARIZONA PEDIATRICS,PLLC
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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1982874319
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARIZONA PEDIATRICS,PLLC
Provider Business Mailing Address
First Line : 600 W THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-4213
Country : US
Telephone Number : 602-277-5731
Fax Number : 602-277-5995
Provider Business Practice Location Address
First Line : 600 W THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-4213
Country : US
Telephone Number : 602-277-5731
Fax Number : 602-277-5995
Authorized Official
Title or Position : PRACTICE MANAGER
Name : MR. MARC PEREZ
Credential : CRTT
Telephone Number : 602-277-5731
Provider Enumeration Date : 02/29/2008
Last Update Date : 02/29/2008

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