| Banner - University Physician Specialists Llc | |
|
17900 N Porter Rd Maricopa AZ 85138-4228 | |
| (520) 233-2500 | |
| (520) 233-2574 |
| Full Name | Banner - University Physician Specialists Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 17900 N Porter Rd, Maricopa, Arizona |
| Authorized Official Name and Position | Dennis Laraway (CHIEF LEGAL OFFICER) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner - University Physician Specialists Llc 2901 N Central Ave Phoenix AZ 85012-2700 Ph: () - | Banner - University Physician Specialists Llc 17900 N Porter Rd Maricopa AZ 85138-4228 Ph: (520) 233-2500 |
| NPI Number | 1063887727 |
|---|---|
| Provider Enumeration Date | 12/07/2015 |
| Last Update Date | 12/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063887727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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