Provider Demographics
NPI:1831195478
Name:SOMMERS, ALAN B (DO)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:B
Last Name:SOMMERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 98819
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-8819
Mailing Address - Country:US
Mailing Address - Phone:602-867-8644
Mailing Address - Fax:602-795-5698
Practice Address - Street 1:3805 E BELL RD
Practice Address - Street 2:SUITE 3100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2105
Practice Address - Country:US
Practice Address - Phone:602-867-8644
Practice Address - Fax:602-795-5698
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ2059207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z1546OtherHEALTHNET
AZ242363Medicaid
AZ25-00727OtherUNITED HEALTHCARE
AZAZ0710140OtherBLUE CROSS BLUE SHIELD
AZ060067349OtherRAILROAD MEDICARE
AZE34695Medicare UPIN
AZ242363Medicaid