Provider Demographics
NPI:1033135223
Name:INTERNISTS, ONCOLOGISTS LTD
Entity Type:Organization
Organization Name:INTERNISTS, ONCOLOGISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DIMPFEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MBA, CHE
Authorized Official - Phone:602-258-4875
Mailing Address - Street 1:1300 N 12TH ST
Mailing Address - Street 2:SUITE 612
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2848
Mailing Address - Country:US
Mailing Address - Phone:602-258-4875
Mailing Address - Fax:602-495-9445
Practice Address - Street 1:1300 N 12TH ST
Practice Address - Street 2:SUITE 612
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2848
Practice Address - Country:US
Practice Address - Phone:602-258-4875
Practice Address - Fax:602-495-9445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWCHDSMedicare PIN