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Organization
HAVASU CARDIAC SURGERY PC
Active
Organization
HAVASU CARDIAC SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PIERRE R TIBI MD (OWNER)
(602) 253-9168
Entity
Organization
Contact information
Practice address
101 CIVIC CENTER LN, ATTN: HAVASU CARDIAC SURGERY, LAKE HAVASU CITY, AZ 86403-5607
(928) 854-0090
(928) 453-0671
Mailing address
3131 E CLARENDON AVE, SUITE 102, PHOENIX, AZ 85016-7069
(602) 253-9168
(602) 251-3126
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
07/02/2006
Last updated
03/10/2008
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