Provider Demographics
NPI:1417019753
Name:HUSBAND, PHILIP J (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:J
Last Name:HUSBAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 33269
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85067-3269
Mailing Address - Country:US
Mailing Address - Phone:602-406-4786
Mailing Address - Fax:
Practice Address - Street 1:1955 W FRYE RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:480-728-3000
Practice Address - Fax:602-230-6461
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01087340A207RC0200X, 207RP1001X
AZ19722207RC0200X
SC87134207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ152885Medicaid
SC871346Medicaid
110209872OtherRR MEDICARE
AZ1Z0742OtherHEALTHNET AZ
AZAZ0848990OtherBCBS AZ
AZZ27292Medicare ID - Type Unspecified