Provider Demographics
NPI:1003129677
Name:UNIVERSITY OBSTETRICS AND GYNECOLOGY PLLC
Entity Type:Organization
Organization Name:UNIVERSITY OBSTETRICS AND GYNECOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTERBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-969-3096
Mailing Address - Street 1:4915 E BASELINE RD
Mailing Address - Street 2:126
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2965
Mailing Address - Country:US
Mailing Address - Phone:480-969-3096
Mailing Address - Fax:480-969-0963
Practice Address - Street 1:4915 E BASELINE RD
Practice Address - Street 2:126
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2965
Practice Address - Country:US
Practice Address - Phone:480-969-3096
Practice Address - Fax:480-969-0963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty