Provider Demographics
NPI:1578821765
Name:ARIZONA ONCOLOGY
Entity Type:Organization
Organization Name:ARIZONA ONCOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA-C
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:ANNA
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:602-283-7927
Mailing Address - Street 1:2222 E HIGHLAND AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4872
Mailing Address - Country:US
Mailing Address - Phone:602-283-7927
Mailing Address - Fax:602-283-3039
Practice Address - Street 1:1760 E RIVER RD
Practice Address - Street 2:SUITE 350
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-5877
Practice Address - Country:US
Practice Address - Phone:520-519-7775
Practice Address - Fax:520-519-7910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4951363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ375883Medicaid