Provider Demographics
NPI:1154052603
Name:HONORHEALTH AMBULATORY
Entity Type:Organization
Organization Name:HONORHEALTH AMBULATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP/CPE
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-587-5123
Mailing Address - Street 1:2500 W UTOPIA RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4171
Mailing Address - Country:US
Mailing Address - Phone:480-587-5314
Mailing Address - Fax:
Practice Address - Street 1:19646 N 27TH AVE STE 407
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4028
Practice Address - Country:US
Practice Address - Phone:602-786-0720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HONORHEALTH AMBULATORY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty