Organization
ST JOSEPHS PATHOLOGY
Active
Other names
PATHOLOGY ASSOCIATES LTD
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY D OLIVER MD (AUTHORIZED REPRESENTATIVE)
(623) 889-7403
Entity
Organization
Contact information
Practice address
350 W THOMAS RD, PHOENIX, AZ 85013-4409
(602) 406-3000
Mailing address
PO BOX 678027, DALLAS, TX 75267-8027
(602) 943-9200
(316) 652-0340
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
454760
—
AZ
01
—
AX4478
HEALTH NET OF AZ
AZ
01
—
AZ0182900
BCBSAZ
AZ
Enumeration date
02/20/2006
Last updated
12/26/2018
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