Organization
ARCADIA PHYSICIANS TRAVEL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER SOUTHWELL MD (MEDICAL DIRECTOR)
(602) 955-8700
Entity
Organization
Contact information
Practice address
4350 E CAMELBACK RD, SUITE F-100, PHOENIX, AZ 85018-2701
(602) 955-8700
(602) 325-0133
Mailing address
4350 E CAMELBACK RD, SUITE F-100, PHOENIX, AZ 85018-2701
(602) 955-8700
(602) 325-0133
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AZ47542
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0861590
BLUE CROSS BLUE SHEILD
AZ
Enumeration date
10/14/2015
Last updated
10/14/2015
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