Provider Demographics
NPI: | 1508924762 |
---|---|
Name: | ARIZONA WELLNESS CENTER FOR WOMEN, P.C. |
Entity Type: | Organization |
Organization Name: | ARIZONA WELLNESS CENTER FOR WOMEN, P.C. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRACTICE MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | VALERIE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SORKIN-WELLS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 602-992-3162 |
Mailing Address - Street 1: | 3815 E BELL RD |
Mailing Address - Street 2: | STE 4500 |
Mailing Address - City: | PHOENIX |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85032-2122 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 602-992-3162 |
Mailing Address - Fax: | 602-992-4393 |
Practice Address - Street 1: | 3815 E BELL RD |
Practice Address - Street 2: | STE 4500 |
Practice Address - City: | PHOENIX |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85032-2122 |
Practice Address - Country: | US |
Practice Address - Phone: | 602-992-3162 |
Practice Address - Fax: | 602-992-4393 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-12-04 |
Last Update Date: | 2008-03-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Single Specialty |