Provider Demographics
NPI:1588680698
Name:CENTRAL ARIZONA UROLOGISTS, LTD
Entity Type:Organization
Organization Name:CENTRAL ARIZONA UROLOGISTS, LTD
Other - Org Name:CENTRAL ARIZONA UROLOGISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:FISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-242-1556
Mailing Address - Street 1:9100 N 2ND ST STE 201
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2450
Mailing Address - Country:US
Mailing Address - Phone:602-242-1556
Mailing Address - Fax:602-242-3099
Practice Address - Street 1:9100 N 2ND ST STE 201
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020
Practice Address - Country:US
Practice Address - Phone:602-242-1556
Practice Address - Fax:602-242-1597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ=========OtherTIN