Provider Demographics
NPI:1114140738
Name:ARIZONA CARDIOVASCULAR SPECIALISTS, P.C.
Entity Type:Organization
Organization Name:ARIZONA CARDIOVASCULAR SPECIALISTS, P.C.
Other - Org Name:THE HEART CENTER OF SOUTHERN ARIZONA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-546-2420
Mailing Address - Street 1:1601 N SWAN RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4046
Mailing Address - Country:US
Mailing Address - Phone:520-615-1023
Mailing Address - Fax:520-546-2934
Practice Address - Street 1:1601 N SWAN RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4046
Practice Address - Country:US
Practice Address - Phone:520-615-1023
Practice Address - Fax:520-546-2934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ67654Medicare PIN