Organization
DESERT SUN PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA R KNAPPER (MANAGER)
(480) 563-1111
Entity
Organization
Contact information
Practice address
26224 N TATUM BLVD, SUITE 1, PHOENIX, AZ 85050-7500
(480) 563-1111
(480) 563-3044
Mailing address
26224 N TATUM BLVD, SUITE 1, PHOENIX, AZ 85050-7500
(480) 563-1111
(480) 563-3044
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
27009
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F07158
PHOENIX HEALTH PLAN GROUP
AZ
01
—
G5263
MERCY CARE GROUP
AZ
Enumeration date
03/16/2007
Last updated
04/22/2008
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