Organization
BANNER-UNIVERSITY MEDICAL CENTER PHX CAMPUS MULTISPECIALTY SERVICES
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS DAHLEN (SR VICE PRESIDENT - FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(602) 239-2391
(602) 239-4362
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
778847
—
AZ
Enumeration date
05/19/2006
Last updated
04/13/2015
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