Provider Demographics
NPI:1720120678
Name:APOLLO HOSPITALISTS PLLC
Entity Type:Organization
Organization Name:APOLLO HOSPITALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:TIGGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-765-9279
Mailing Address - Street 1:1955 W BASELINE RD # 113-647
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-9003
Mailing Address - Country:US
Mailing Address - Phone:480-626-4813
Mailing Address - Fax:480-445-9238
Practice Address - Street 1:1400 S DOBSON RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4707
Practice Address - Country:US
Practice Address - Phone:480-626-4813
Practice Address - Fax:480-445-9238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ348469Medicaid
AZ348469Medicaid