Organization
ARIZONA STATE UNIVERSITY
Active
Parent organization
ARIZONA STATE UNIVERSITY
Other names
Arizona State University Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
ARIZONA STATE UNIVERSITY
Authorized official
DR. ALLAN MARKUS M.D. (PHYSICIAN/DIRECTOR)
(480) 965-1145
Entity
Organization
Contact information
Practice address
4701 WEST THUNDERBIRD ROAD, UNIVERSITY CENTER BUILDING, ROOM 190, GLENDALE, AZ 85306
(602) 543-8019
(602) 543-8079
Mailing address
PO BOX 872104, TEMPE, AZ 85287-2104
(480) 965-3346
(480) 965-2269
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
AZ
207Q00000X
Family Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
AZ
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/06/2007
Last updated
11/03/2014
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