Organization
EMERGENCY PHYSICIANS SOUTHWEST, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON HARDY (DIRECTOR PROVIDER ENROLLMENT)
(925) 251-6901
Entity
Organization
Contact information
Practice address
6644 E BAYWOOD AVE, MESA, AZ 85206-1747
(480) 321-2000
(480) 321-4198
Mailing address
PO BOX 635623, CINCINNATI, OH 45263-0001
(925) 924-1600
(925) 924-0506
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
443747
—
AZ
01
—
DF7231
MEDICARE RR
AZ
Enumeration date
01/26/2007
Last updated
01/10/2020
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