Provider Demographics
NPI:1184870560
Name:DESERT HEART SURGERY SPECIALISTS, PLLC
Entity type:Organization
Organization Name:DESERT HEART SURGERY SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:VON HAAG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-222-8065
Mailing Address - Street 1:7850 N SILVERBELL RD STE 114-360
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-8219
Mailing Address - Country:US
Mailing Address - Phone:520-222-8065
Mailing Address - Fax:520-232-2313
Practice Address - Street 1:7850 N SILVERBELL RD STE 114-360
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-8219
Practice Address - Country:US
Practice Address - Phone:520-222-8065
Practice Address - Fax:520-232-2313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32835208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty