Provider Demographics
NPI:1578895769
Name:MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH
Entity Type:Organization
Organization Name:MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:NE
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-506-6662
Mailing Address - Street 1:4041 N CENTRAL AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-3330
Mailing Address - Country:US
Mailing Address - Phone:602-506-6662
Mailing Address - Fax:
Practice Address - Street 1:4041 N CENTRAL AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-3330
Practice Address - Country:US
Practice Address - Phone:602-506-6662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-12
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ097451Medicaid