Provider Demographics
NPI:1922203728
Name:ARIZONA ONCOLOGY SERVICES OF YUMA
Entity Type:Organization
Organization Name:ARIZONA ONCOLOGY SERVICES OF YUMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:BEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-240-3395
Mailing Address - Street 1:300 W CLARENDON AVE
Mailing Address - Street 2:SUITE #350
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3420
Mailing Address - Country:US
Mailing Address - Phone:602-240-3395
Mailing Address - Fax:602-240-3539
Practice Address - Street 1:300 W CLARENDON AVE
Practice Address - Street 2:SUITE #350
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3420
Practice Address - Country:US
Practice Address - Phone:602-240-3395
Practice Address - Fax:602-240-3539
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIZONA ONCOLOGY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-20
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWCHJD14Medicare PIN
AZZ28348Medicare PIN
AZZ30WCHJD07Medicare PIN
AZZ76882Medicare PIN