Provider Demographics
NPI:1558656272
Name:SOUTHWEST CHEST CONSULTANTS PC
Entity Type:Organization
Organization Name:SOUTHWEST CHEST CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-767-8811
Mailing Address - Street 1:10277 N 92ND ST
Mailing Address - Street 2:STE 103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4564
Mailing Address - Country:US
Mailing Address - Phone:480-767-8811
Mailing Address - Fax:480-657-0737
Practice Address - Street 1:10277 N 92ND ST
Practice Address - Street 2:STE 103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4564
Practice Address - Country:US
Practice Address - Phone:480-767-8811
Practice Address - Fax:480-657-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11320207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ146168Medicare PIN