Provider Demographics
NPI: | 1578587671 |
---|---|
Name: | ARIZONA ONCOLOGY ASSOCIATES, PC |
Entity Type: | Organization |
Organization Name: | ARIZONA ONCOLOGY ASSOCIATES, PC |
Other - Org Name: | ARIZONA ONCOLOGY |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ROBERT |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 520-519-7700 |
Mailing Address - Street 1: | PO BOX 910221 |
Mailing Address - Street 2: | |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75391-0221 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 520-519-7700 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2625 N CRAYCROFT RD STE 221 |
Practice Address - Street 2: | |
Practice Address - City: | TUCSON |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85712-2268 |
Practice Address - Country: | US |
Practice Address - Phone: | 520-519-7775 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-07-26 |
Last Update Date: | 2024-02-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AZ | 174400000X, 207R00000X, 207RH0000X, 207RH0003X, 207RI0200X, 207RX0202X, 207V00000X, 207VG0400X, 207VX0000X, 207VX0201X, 2085R0001X, 2085R0202X, 208800000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 174400000X | Other Service Providers | Specialist | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RH0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | Group - Multi-Specialty |
No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
No | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | Group - Multi-Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207VG0400X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | Group - Multi-Specialty |
No | 207VX0000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics | Group - Multi-Specialty |
No | 207VX0201X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology | Group - Multi-Specialty |
No | 2085R0001X | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | Group - Multi-Specialty |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AZ | Z151000 | Medicare PIN | |
AZ | Z25291 | Medicare PIN | |
AZ | Z25328 | Medicare PIN | |
AZ | Z60075 | Medicare PIN | |
AZ | Z143026 | Medicare UPIN | |
AZ | Z25325 | Medicare PIN | |
AZ | Z25323 | Medicare PIN |