Provider Demographics
NPI:1467542787
Name:PINNACLE INTERNAL MEDICINE
Entity Type:Organization
Organization Name:PINNACLE INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-845-0664
Mailing Address - Street 1:8466 W PEORIA AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-6548
Mailing Address - Country:US
Mailing Address - Phone:623-845-0664
Mailing Address - Fax:623-845-0667
Practice Address - Street 1:8466 W PEORIA AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-6548
Practice Address - Country:US
Practice Address - Phone:623-845-0664
Practice Address - Fax:623-845-0667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28668207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty