Provider Demographics
NPI:1629241807
Name:ARIZONA VULVA CLINIC, PLLC
Entity Type:Organization
Organization Name:ARIZONA VULVA CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:AD
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-265-1112
Mailing Address - Street 1:300 W CLARENDON AVE STE 100
Mailing Address - Street 2:300 W. CLARENDON, #100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3421
Mailing Address - Country:US
Mailing Address - Phone:602-265-1112
Mailing Address - Fax:602-264-4101
Practice Address - Street 1:300 W CLARENDON AVE STE 100
Practice Address - Street 2:300 W. CLARENDON, #100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3421
Practice Address - Country:US
Practice Address - Phone:602-265-1112
Practice Address - Fax:602-264-4101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty