Provider Demographics
NPI:1275620486
Name:SOUTHWEST MEDICAL ASSOCIATES LTD.
Entity Type:Organization
Organization Name:SOUTHWEST MEDICAL ASSOCIATES LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:METZGER
Authorized Official - Suffix:
Authorized Official - Credentials:D O
Authorized Official - Phone:480-964-0080
Mailing Address - Street 1:455 E 4TH PL
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-7101
Mailing Address - Country:US
Mailing Address - Phone:480-964-0080
Mailing Address - Fax:480-644-0931
Practice Address - Street 1:455 E 4TH PL
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-7101
Practice Address - Country:US
Practice Address - Phone:480-964-0080
Practice Address - Fax:480-644-0931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2291207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ02216OtherBCBS AZ GROUP-SW MEDICAL
AZ516213OtherAHCCCS MEDICARE
AZZWCHJJMedicare ID - Type UnspecifiedGROUP-SW MEDICAL
AZ516213OtherAHCCCS > MEDICARE