Provider Demographics
NPI:1720005432
Name:ARIZONA GASTROENTEROLOGY CONSULTANTS LTD
Entity Type:Organization
Organization Name:ARIZONA GASTROENTEROLOGY CONSULTANTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABRAMS
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-242-2555
Mailing Address - Street 1:6707 N 19TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-1104
Mailing Address - Country:US
Mailing Address - Phone:602-242-2555
Mailing Address - Fax:602-242-5415
Practice Address - Street 1:6707 N 19TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1104
Practice Address - Country:US
Practice Address - Phone:602-242-2555
Practice Address - Fax:602-242-5415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ64632Medicare PIN
AZZ64635Medicare PIN
AZZ64634Medicare PIN