Organization
SEVILLE FAMILY PHYSICIANS
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS DAHLEN (SR VICE PRESIDENT)
(602) 747-4000
Entity
Organization
Contact information
Practice address
3336 E CHANDLER HEIGHTS RD, BLDG. A, SUITE 101, GILBERT, AZ 85297-4259
(480) 512-5900
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
972845
—
AZ
Enumeration date
06/19/2006
Last updated
10/15/2007
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