Organization
BANNER - UNIVERSITY HOSPITAL BASED PHYSICIANS LLC
Active
Parent organization
BANNER -- UNIVERSITY MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER -- UNIVERSITY MEDICAL GROUP
Authorized official
TODD WERNER (DIVISION PRESIDENT)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(602) 839-3749
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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