Provider Demographics
NPI:1467759092
Name:ARIZONA PHYSICIAN CONSULTANTS PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ARIZONA PHYSICIAN CONSULTANTS PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:J
Authorized Official - Last Name:EHLERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-726-6335
Mailing Address - Street 1:DEPT 5258
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90084-5258
Mailing Address - Country:US
Mailing Address - Phone:330-470-3700
Mailing Address - Fax:330-470-3753
Practice Address - Street 1:1501 W 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6373
Practice Address - Country:US
Practice Address - Phone:928-726-6335
Practice Address - Fax:928-726-6501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty