# HEART INSTITUTE OF NORTHERN ARIZONA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013189893
- **Authorized official:** DR. A PAUL KALANITHI M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (928) 757-4359

## Contact information

- **Practice address:** 1753 AIRWAY AVE, SUITE B, KINGMAN, AZ 86409-3720
- **Practice address phone:** (928) 692-6200
- **Practice address fax:** (928) 692-9474
- **Mailing address:** 1753 AIRWAY AVE, SUITE B, KINGMAN, AZ 86409-3720
- **Mailing address phone:** (928) 692-6200
- **Mailing address fax:** (928) 692-9474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | OTC710 | AZ | Yes |

## Other

- **Enumeration date:** 04/01/2008
- **Last updated:** 04/27/2009