Provider Demographics
NPI:1497771968
Name:NORTHWEST THORACIC SURGERY
Entity Type:Organization
Organization Name:NORTHWEST THORACIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ARZOUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-603-1759
Mailing Address - Street 1:PO BOX 30866
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-0866
Mailing Address - Country:US
Mailing Address - Phone:520-603-1759
Mailing Address - Fax:520-529-0667
Practice Address - Street 1:1521 E TANGERINE RD
Practice Address - Street 2:SUITE 161
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-6225
Practice Address - Country:US
Practice Address - Phone:520-603-1759
Practice Address - Fax:520-529-0667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23550208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZG18896Medicare UPIN