Individual
MR. THOMAS CLAIBORNE WAITZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7720 NORTH 17TH AVENUE, PHOENIX, AZ 85021
(602) 997-6062
(602) 870-3130
Mailing address
7720 NORTH 17TH AVENUE, PHOENIX, AZ 85021
(602) 997-6062
(602) 870-3130
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
007083
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227901
STATE AHCCCS
AZ
Enumeration date
03/01/2006
Last updated
07/08/2007
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