Provider Demographics
NPI:1972267896
Name:IRONWOOD HEALTH LLC
Entity Type:Organization
Organization Name:IRONWOOD HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:JEFFERY
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:520-225-7006
Mailing Address - Street 1:9241 N RALEIGH DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-3628
Mailing Address - Country:US
Mailing Address - Phone:520-225-7006
Mailing Address - Fax:
Practice Address - Street 1:9241 N RALEIGH DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-3628
Practice Address - Country:US
Practice Address - Phone:520-225-7006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty