Provider Demographics
NPI:1770892879
Name:AZ PSYCHIATRIC ASSOCIATES, PLLC
Entity type:Organization
Organization Name:AZ PSYCHIATRIC ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-253-5100
Mailing Address - Street 1:3030 N CENTRAL AVE STE 1407
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2720
Mailing Address - Country:US
Mailing Address - Phone:602-253-5100
Mailing Address - Fax:602-416-7700
Practice Address - Street 1:3030 N CENTRAL AVE STE 1407
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2720
Practice Address - Country:US
Practice Address - Phone:602-253-5100
Practice Address - Fax:602-416-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ332312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty