Provider Demographics
NPI:1659516987
Name:NORTHERN ARIZONA PULMONARY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NORTHERN ARIZONA PULMONARY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:MAPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-773-0003
Mailing Address - Street 1:1360 N RIM DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3111
Mailing Address - Country:US
Mailing Address - Phone:928-774-8000
Mailing Address - Fax:928-774-0372
Practice Address - Street 1:1360 N RIM DR
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3111
Practice Address - Country:US
Practice Address - Phone:928-774-8000
Practice Address - Fax:928-774-0372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ401278Medicaid
D07083OtherRR MEDICARE PTAN
Z127855Medicare Oscar/Certification