Organization
PARADISE VALLEY ALLERGY ASSOC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD GEORGE KEIGHTLEY MD (CEO)
(480) 991-1930
Entity
Organization
Contact information
Practice address
20940 N TATUM BLVD, STE 205, PHOENIX, AZ 85050-7260
(480) 991-1930
(480) 443-8196
Mailing address
20940 N TATUM BLVD, STE 205, PHOENIX, AZ 85050-7260
(480) 991-1930
(480) 443-8196
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
11856
AZ
2080P0201X
Pediatric Allergy/Immunology Physician
11856
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200027
UNITED HEATH CARE
AZ
01
—
1Z2992
HEALTHNET
AZ
01
—
2572627
AETNA HMO
AZ
01
—
4022160
AETNA PPO
AZ
01
—
AZ0027920
BCBS
AZ
Enumeration date
11/16/2006
Last updated
03/14/2012
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