Provider Demographics
NPI:1285798827
Name:PHOENIX INFECTIOUS DISEASE SPECIALISTS P C
Entity type:Organization
Organization Name:PHOENIX INFECTIOUS DISEASE SPECIALISTS P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:E
Authorized Official - Last Name:SPOONER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-282-4455
Mailing Address - Street 1:PO BOX 1761
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86339-1761
Mailing Address - Country:US
Mailing Address - Phone:928-282-4455
Mailing Address - Fax:928-282-6677
Practice Address - Street 1:35 DRY CREEK RD
Practice Address - Street 2:SUITE # ONE
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-4359
Practice Address - Country:US
Practice Address - Phone:928-282-4455
Practice Address - Fax:928-282-6677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ07-440472V207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty