Provider Demographics
NPI:1972125490
Name:ARIZONA MEDICAL SPECIALTY GROUP, LLC
Entity Type:Organization
Organization Name:ARIZONA MEDICAL SPECIALTY GROUP, LLC
Other - Org Name:IMMEDIATE CARE ARIZONA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:SKINNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD, PHD, MBA
Authorized Official - Phone:520-800-8229
Mailing Address - Street 1:5590 E RIVER RD STE 150
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1925
Mailing Address - Country:US
Mailing Address - Phone:520-800-8229
Mailing Address - Fax:520-369-2154
Practice Address - Street 1:5590 E RIVER RD.
Practice Address - Street 2:SUITE 150
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750
Practice Address - Country:US
Practice Address - Phone:520-800-8229
Practice Address - Fax:520-369-2154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty