Provider Demographics
NPI:1356397921
Name:SAGUARO PHYSICIANS, LLC
Entity type:Organization
Organization Name:SAGUARO PHYSICIANS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-324-4419
Mailing Address - Street 1:P.O. BOX 31235
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1235
Mailing Address - Country:US
Mailing Address - Phone:520-324-4100
Mailing Address - Fax:520-324-2567
Practice Address - Street 1:4881 E GRANT RD
Practice Address - Street 2:STE 201
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2704
Practice Address - Country:US
Practice Address - Phone:520-324-4100
Practice Address - Fax:520-324-1406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28486207R00000X
AZ27674207R00000X
AZ29548207R00000X
AZ2863363A00000X
AZ9450207R00000X
AZ22533207RR0500X
AZ28439207R00000X
AZ34674207R00000X
AZ23902207RR0500X
AZ2190363A00000X
AZ34023207X00000X
AZRN041490363LF0000X
AZ36813207Q00000X
AZ13289207R00000X
AZ3134207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ310321Medicaid
AZZ78602Medicare PIN