Provider Demographics
NPI:1376576348
Name:PROSTATE SOLUTIONS OF ARIZONA, P.C.
Entity Type:Organization
Organization Name:PROSTATE SOLUTIONS OF ARIZONA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:BANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-426-9772
Mailing Address - Street 1:2525 E ARIZONA BILTMORE CIR
Mailing Address - Street 2:SUITE C-236
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-2146
Mailing Address - Country:US
Mailing Address - Phone:602-426-9772
Mailing Address - Fax:602-426-9775
Practice Address - Street 1:1 E CAMELBACK RD
Practice Address - Street 2:SUITE 700
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1668
Practice Address - Country:US
Practice Address - Phone:602-748-1100
Practice Address - Fax:602-748-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty