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Contact Information

MEDICAL GROUP OF ARIZONA, LLC
13430 N. BLACK CANYON HIGHWAY
SUITE 100
PHOENIX, AZ85029-1310
 Phone: 602-943-9200
 Fax: 602-216-3000
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for MEDICAL GROUP OF ARIZONA, LLC

NPI Number 1366796773
LBN Legal business name MEDICAL GROUP OF ARIZONA, LLC
Authorized official REGINALD SUTTON - (SOLE MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/07/2012
Last updated 11/07/2012 - About 14 years ago
Identifiers
AZ License # 29166
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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