Organization
PHYSICIAN GROUP OF ARIZONA INC
Active
Other names
Steward Medical Group of Arizona
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY KOCH (CFO)
(617) 562-7070
Entity
Organization
Contact information
Practice address
4801 E WASHINGTON ST, SUITE 200, PHOENIX, AZ 85034-2004
(602) 507-4500
(602) 688-8311
Mailing address
PO BOX 281201, ATLANTA, GA 30384-1201
(866) 243-7104
(314) 432-9683
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323426
—
AZ
Enumeration date
03/05/2008
Last updated
03/06/2020
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