Provider Demographics
NPI:1518047448
Name:APPLETREE FAMILY LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:APPLETREE FAMILY LIMITED PARTNERSHIP
Other - Org Name:BREAST EVALUATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:C
Authorized Official - Last Name:SIPES
Authorized Official - Suffix:
Authorized Official - Credentials:RT, RDMS
Authorized Official - Phone:602-279-7871
Mailing Address - Street 1:PO BOX 33336
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85067-3336
Mailing Address - Country:US
Mailing Address - Phone:602-279-7871
Mailing Address - Fax:602-279-8042
Practice Address - Street 1:3330 N 2ND ST
Practice Address - Street 2:SUITE 206
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2368
Practice Address - Country:US
Practice Address - Phone:602-279-7871
Practice Address - Fax:602-279-8042
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
AZ7MM34112085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ79781Medicare PIN