Organization
MEDICAL PROFESSIONAL ASSOCIATES OF ARIZONA
Active
Organization
MEDICAL PROFESSIONAL ASSOCIATES OF ARIZONA
Active
Parent organization
MEDICAL PROFESSIONAL ASSOCIATES OF ARIZONA
Other names
MedPro
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL PROFESSIONAL ASSOCIATES OF ARIZONA
Authorized official
TERESA CORDEIRO (CREDENTIALING MANAGER)
(602) 470-5043
Entity
Organization
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5098
(602) 344-1488
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
(602) 470-5064
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
69317
MEDICARE ID GROUP #
AZ
Enumeration date
08/07/2007
Last updated
06/10/2008
Update your record
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