Provider Demographics
NPI:1740294420
Name:ENDOCRINOLOGY ASSOCIATES P A DTD
Entity type:Organization
Organization Name:ENDOCRINOLOGY ASSOCIATES P A DTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FRONT OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-266-8463
Mailing Address - Street 1:9328 E RAINTREE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2098
Mailing Address - Country:US
Mailing Address - Phone:602-266-8463
Mailing Address - Fax:602-266-0122
Practice Address - Street 1:9328 E RAINTREE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2098
Practice Address - Country:US
Practice Address - Phone:602-266-8463
Practice Address - Fax:602-266-0122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ494995Medicaid
ZWDCDRMedicare ID - Type Unspecified