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Contact Information

INTEGRATED PREMIER GROUP SPECIALTY, LLC
2075 S COTTONWOOD DR
TEMPE, AZ85282-3040
 Phone: 480-718-0568
 Fax: 480-307-6676
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family

103TF0000X 62 Psychologist, Clinical
 

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Podiatrist

213E00000X 48 Podiatry
 

Psychologist

103T00000X 62 Psychologist, Clinical
 

Social Worker

104100000X
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for INTEGRATED PREMIER GROUP SPECIALTY, LLC

NPI # 1770961914
LBN Legal business name INTEGRATED PREMIER GROUP SPECIALTY, LLC
Authorized official FERAS ALDAOUD - (PROVIDER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/07/2015
Last updated 03/19/2020 - About 6 years ago
Identifiers
AZ License # 18871
AZ Medicaid 208912
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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