Organization
CIGNA HEALTH CARE OF ARIZONA INC.
Active
Other names
EVERNORTH Care Group South Mountain Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN ELLIS D.O. (CHIEF MEDICAL DIRECTOR)
(623) 277-2246
Entity
Organization
Contact information
Practice address
7236 S CENTRAL AVE, PHOENIX, AZ 85042-5425
(602) 276-5565
Mailing address
8888 E RAINTREE DR FL 3, SCOTTSDALE, AZ 85260-3951
(602) 328-8400
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
OTC 0648
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061812
—
AZ
Enumeration date
11/13/2006
Last updated
06/16/2023
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