Provider Demographics
NPI:1700073426
Name:VALLEY INTERGRATIVE PHYSICIANS PLLC
Entity Type:Organization
Organization Name:VALLEY INTERGRATIVE PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:W
Authorized Official - Last Name:HUEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-504-1000
Mailing Address - Street 1:14231 N 7TH ST
Mailing Address - Street 2:SUITE A2
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4360
Mailing Address - Country:US
Mailing Address - Phone:602-504-1000
Mailing Address - Fax:602-504-1008
Practice Address - Street 1:14231 N 7TH ST
Practice Address - Street 2:SUITE A2
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4360
Practice Address - Country:US
Practice Address - Phone:602-504-1000
Practice Address - Fax:602-504-1008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5050111N00000X
AZ7022111N00000X
AZ7101207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ64426OtherTPAN
AZT05237Medicare UPIN
AZZ64426OtherTPAN
AZT53069Medicare UPIN