Provider Demographics
| NPI: | 1205871076 |
|---|---|
| Name: | ARIZONA COMMUNITY PHYSICIANS PC |
| Entity type: | Organization |
| Organization Name: | ARIZONA COMMUNITY PHYSICIANS PC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JIM |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | STELZER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 520-327-0460 |
| Mailing Address - Street 1: | 5055 E BROADWAY BLVD |
| Mailing Address - Street 2: | SUITE A100 |
| Mailing Address - City: | TUCSON |
| Mailing Address - State: | AZ |
| Mailing Address - Zip Code: | 85711-3640 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 520-327-0460 |
| Mailing Address - Fax: | 520-795-0225 |
| Practice Address - Street 1: | 5055 E BROADWAY BLVD |
| Practice Address - Street 2: | SUITE A100 |
| Practice Address - City: | TUCSON |
| Practice Address - State: | AZ |
| Practice Address - Zip Code: | 85711-3640 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 520-327-0460 |
| Practice Address - Fax: | 520-795-0225 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-06-17 |
| Last Update Date: | 2024-12-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207QG0300X | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | Group - Multi-Specialty |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | Group - Multi-Specialty |
| No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
| No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Multi-Specialty |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | Group - Multi-Specialty |
| No | 207VG0400X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | Group - Multi-Specialty |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 261QM1200X | Ambulatory Health Care Facilities | Clinic/Center | Magnetic Resonance Imaging (MRI) | Group - Multi-Specialty |
| No | 261QR0200X | Ambulatory Health Care Facilities | Clinic/Center | Radiology | Group - Multi-Specialty |
| No | 291U00000X | Laboratories | Clinical Medical Laboratory | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
| No | 363LG0600X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| AZ | ZWDBCR | Other | MEDICARE ID - TYPE UNSPEC |
