Provider Demographics
NPI:1013901586
Name:AYANZEN, RON H (MD)
Entity Type:Individual
Prefix:
First Name:RON
Middle Name:H
Last Name:AYANZEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 E CAMELBACK RD
Mailing Address - Street 2:STE 137
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-2773
Mailing Address - Country:US
Mailing Address - Phone:480-269-2727
Mailing Address - Fax:480-269-2727
Practice Address - Street 1:8100 E CAMELBACK RD
Practice Address - Street 2:STE 137
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2773
Practice Address - Country:US
Practice Address - Phone:480-269-2727
Practice Address - Fax:480-269-2727
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ259132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ300118029OtherRAILROAD MEDICARE
AZ529240Medicaid
AZ1013901586OtherNPI
AZ1013901586OtherNPI
AZZ63274Medicare PIN