Provider Demographics
NPI:1073608147
Name:AN OZKAN MD PC
Entity Type:Organization
Organization Name:AN OZKAN MD PC
Other - Org Name:AN OZKAN MD PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADIL
Authorized Official - Middle Name:NURI
Authorized Official - Last Name:OZKAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-512-4190
Mailing Address - Street 1:PO BOX 52457
Mailing Address - Street 2:DEPT 3037
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85072-2457
Mailing Address - Country:US
Mailing Address - Phone:480-314-7528
Mailing Address - Fax:
Practice Address - Street 1:13555 W MCDOWELL RD
Practice Address - Street 2:SUITE 201B
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-2624
Practice Address - Country:US
Practice Address - Phone:623-512-4190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23460207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ79574Medicare PIN