Provider Demographics
NPI: | 1841861143 |
---|---|
Name: | HONORHEALTH AMBULATORY |
Entity type: | Organization |
Organization Name: | HONORHEALTH AMBULATORY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SVP/CPE |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JOHN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NEIL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 480-587-5123 |
Mailing Address - Street 1: | 2500 W UTOPIA RD |
Mailing Address - Street 2: | |
Mailing Address - City: | PHOENIX |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85027-4171 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 480-587-5314 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3645 S ROME ST STE 204 |
Practice Address - Street 2: | |
Practice Address - City: | GILBERT |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85297-7338 |
Practice Address - Country: | US |
Practice Address - Phone: | 480-534-4520 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-07-07 |
Last Update Date: | 2025-03-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 2086X0206X | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology | Group - Multi-Specialty |