Organization
PREMISE HEALTH OF ARIZONA MEDICAL, P.C.
Active
Other names
Maricopa Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN M.D. (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
301 W JEFFERSON ST STE 201, PHOENIX, AZ 85003-2195
(480) 347-4791
(480) 347-4792
Mailing address
16906 COLLECTION CENTER DR, CHICAGO, IL 60693-0169
(877) 865-9013
(480) 347-4792
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
05/10/2012
Last updated
08/23/2022
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