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Organization
PRIVIA MEDICAL GROUP ARIZONA, LLC
Active
Organization
PRIVIA MEDICAL GROUP ARIZONA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MCHORNEY (CFO)
(602) 633-3838
Entity
Organization
Contact information
Practice address
3815 E BELL RD STE 4500, PHOENIX, AZ 85032-2171
(602) 633-3838
(602) 633-3838
Mailing address
3815 E BELL RD STE 4500, PHOENIX, AZ 85032-2171
(602) 633-3838
(602) 633-3841
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207VG0400X
Gynecology Physician
—
NULL
207VG0400X
Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
2085R0001X
Radiation Oncology Physician
—
NULL
2085R0001X
Radiation Oncology Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
NULL
208800000X
Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
326831
—
AZ
Enumeration date
03/22/2006
Last updated
05/02/2025
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