Provider Demographics
NPI:1225398233
Name:C. STEVEN PLIMPTON
Entity Type:Organization
Organization Name:C. STEVEN PLIMPTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEC/BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLIMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-418-8119
Mailing Address - Street 1:515 EAST THOMAS ROAD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012
Mailing Address - Country:US
Mailing Address - Phone:602-418-8119
Mailing Address - Fax:
Practice Address - Street 1:515 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-3203
Practice Address - Country:US
Practice Address - Phone:602-241-1717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20429207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ105818Medicaid