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Organization
ARIZONA EMERGENCY SPECIALIST, PC
Active
Organization
ARIZONA EMERGENCY SPECIALIST, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER A WILLCOX MD (PRESIDENT)
(602) 923-5000
Entity
Organization
Contact information
Practice address
3929 E BELL RD, PHOENIX, AZ 85032-2112
(602) 923-5000
(818) 587-2493
Mailing address
PO BOX 80072, CITY OF INDUSTRY, CA 91716-8072
(818) 340-9988
(818) 587-2493
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
973596
—
AZ
01
—
AZ0306240
BLUE SHIELD
AZ
Enumeration date
07/11/2006
Last updated
08/22/2020
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