Provider Demographics
NPI:1932312188
Name:CAROL J PEAIRS MD
Entity Type:Organization
Organization Name:CAROL J PEAIRS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEAIRS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-867-3270
Mailing Address - Street 1:PO BOX 30305
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85046-0305
Mailing Address - Country:US
Mailing Address - Phone:602-971-7073
Mailing Address - Fax:602-971-1706
Practice Address - Street 1:5901 E VIA DEL CIELO
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-8107
Practice Address - Country:US
Practice Address - Phone:480-443-9186
Practice Address - Fax:602-971-1706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15474207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ73317Medicare PIN
AZD37433Medicare UPIN