Northwest Ob/gyn | |
2055 W Hospital Dr Ste 115 Tucson AZ 85704-7823 | |
(520) 797-0011 | |
(520) 797-7550 |
Full Name | Northwest Ob/gyn |
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Speciality | Clinic/Center |
Location | 2055 W Hospital Dr Ste 115, Tucson, Arizona |
Authorized Official Name and Position | Joshua B Carzoli (CEO) |
Authorized Official Contact | 5206824111 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Northwest Ob/gyn Po Box 188 Marana AZ 85653-0188 Ph: (520) 797-0011 | Northwest Ob/gyn 2055 W Hospital Dr Ste 115 Tucson AZ 85704-7823 Ph: (520) 797-0011 |
NPI Number | 1407915630 |
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Provider Enumeration Date | 12/06/2006 |
Last Update Date | 05/06/2024 |
Medicare PECOS PAC ID | 2365348091 |
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Medicare Enrollment ID | O20070203000098 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407915630 | NPI | - | NPPES |
928952 | Medicaid | AZ | |
329592 | Other | AZ | AHCCCS GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Arizona) | Primary |
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