# PHOENIX CARDIAC SURGERY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** YAVAPAI CARDIAC SURGERY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619169950
- **Authorized official:** DR. PIERRE R TIBI MD (OWNER)
- **Authorized official phone:** (602) 253-9168

## Contact information

- **Practice address:** 811 AINSWORTH DR, SUITE 109, PRESCOTT, AZ 86301-1687
- **Practice address phone:** (928) 771-5595
- **Mailing address:** 3131 E CLARENDON AVE, SUITE 102, PHOENIX, AZ 85016-7069
- **Mailing address phone:** (602) 253-9168

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/10/2007
- **Last updated:** 01/07/2015