Provider Demographics
NPI:1275887028
Name:CIGNA HEALTHCARE OF ARIZONA, INC.
Entity Type:Organization
Organization Name:CIGNA HEALTHCARE OF ARIZONA, INC.
Other - Org Name:CIGNA MEDICAL GROUP PHOENIX CENTRAL URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:BURRELL
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:623-277-1105
Mailing Address - Street 1:25500 N NORTERRA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-8200
Mailing Address - Country:US
Mailing Address - Phone:623-277-2335
Mailing Address - Fax:623-277-1203
Practice Address - Street 1:3003 N 3RD ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-3031
Practice Address - Country:US
Practice Address - Phone:602-282-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-01
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care