| Banner Physician Super Specialists Arizona Llc | |
|
37100 N Gantzel Rd Ste 113 San Tan Valley AZ 85140-7349 | |
| (480) 412-9400 | |
| Not Available |
| Full Name | Banner Physician Super Specialists Arizona Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 37100 N Gantzel Rd, San Tan Valley, Arizona |
| Authorized Official Name and Position | Dennis Laraway (CFO) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Physician Super Specialists Arizona Llc 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | Banner Physician Super Specialists Arizona Llc 37100 N Gantzel Rd Ste 113 San Tan Valley AZ 85140-7349 Ph: (480) 412-9400 |
| NPI Number | 1396014403 |
|---|---|
| Provider Enumeration Date | 12/19/2011 |
| Last Update Date | 12/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396014403 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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O.serrano, M.d. Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 37100 N Gantzel Rd, San Tan Valley, AZ 85140 Phone: 480-461-1135 Fax: 480-461-1138 | |
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Banner Hospital Based Physicians Arizona Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 37000 N Gantzel Rd, San Tan Valley, AZ 85140 Phone: 480-543-2034 | |
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San Tan Primary Care Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 36283 N Gantzel Rd Ste 101, San Tan Valley, AZ 85140 Phone: 480-351-7277 Fax: 480-219-5457 |