Organization
THOMAS C WAITZ MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS CLAIBORNE WAITZ MD (PRESIDENT OF PC)
(602) 997-6062
Entity
Organization
Contact information
Practice address
7720 N 17TH AVE, PHOENIX, AZ 85021-7010
(602) 997-6062
(602) 870-3130
Mailing address
7720 N 17TH AVE, PHOENIX, AZ 85021-7010
(602) 997-6062
(602) 870-3130
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
7083
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227901
AHCCCS PLANS
AZ
Enumeration date
01/29/2008
Last updated
01/29/2008
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