Provider Demographics
NPI:1033114210
Name:REGIONAL CARE PHYSICIANS GROUP, INC.
Entity Type:Organization
Organization Name:REGIONAL CARE PHYSICIANS GROUP, INC.
Other - Org Name:DESERT SQUARO MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMPSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-381-6300
Mailing Address - Street 1:1828 E FLORENCE BLVD
Mailing Address - Street 2:BUILDING C, STE 142
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-4783
Mailing Address - Country:US
Mailing Address - Phone:520-876-4881
Mailing Address - Fax:520-836-1932
Practice Address - Street 1:1828 E FLORENCE BLVD
Practice Address - Street 2:BUILDING C, STE 142
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-4783
Practice Address - Country:US
Practice Address - Phone:520-876-4881
Practice Address - Fax:520-836-1932
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASA GRNADE REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-15
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZB47184207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ860427850OtherEIN