Provider Demographics
NPI:1578012308
Name:INTEGRATED MEDICAL PHYSICIANS LLC
Entity Type:Organization
Organization Name:INTEGRATED MEDICAL PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:JARVINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-448-9990
Mailing Address - Street 1:3317 S HIGLEY RD STE 114-153
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-5442
Mailing Address - Country:US
Mailing Address - Phone:480-448-9990
Mailing Address - Fax:480-448-9252
Practice Address - Street 1:1301 S CRISMON RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3767
Practice Address - Country:US
Practice Address - Phone:480-261-5319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2023-03-02
Deactivation Date:2019-02-27
Deactivation Code:
Reactivation Date:2022-11-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty