Provider Demographics
NPI:1689907453
Name:ANTHONY C. POZUN, D.O., PLLC
Entity Type:Organization
Organization Name:ANTHONY C. POZUN, D.O., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:POZUN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-978-0154
Mailing Address - Street 1:5620 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE E-1
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4636
Mailing Address - Country:US
Mailing Address - Phone:602-978-0154
Mailing Address - Fax:602-978-2797
Practice Address - Street 1:5620 W THUNDERBIRD RD
Practice Address - Street 2:SUITE E-1
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4636
Practice Address - Country:US
Practice Address - Phone:602-978-0154
Practice Address - Fax:602-978-2797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3684207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ092660Medicaid
AZ110077Medicare PIN
AZ092660Medicaid