Organization
BANNER CANCER CENTER SPECIALISTS LLC
Active
Parent organization
BANNER MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER MEDICAL GROUP
Authorized official
SHIVA BIRDI (CEO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
807 S PONDEROSA ST, PAYSON, AZ 85541-5542
(928) 471-3222
(928) 472-3404
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
261QX0200X
Oncology Clinic/Center
Primary
—
—
Other
Enumeration date
06/14/2018
Last updated
03/06/2025
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