Provider Demographics
NPI:1306947684
Name:ARIZONA LUNG & CRITICAL CARE SPECIALISTS PC
Entity type:Organization
Organization Name:ARIZONA LUNG & CRITICAL CARE SPECIALISTS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-657-8800
Mailing Address - Street 1:10290 N 92ND ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4522
Mailing Address - Country:US
Mailing Address - Phone:480-657-8800
Mailing Address - Fax:480-661-0149
Practice Address - Street 1:10290 N 92ND ST
Practice Address - Street 2:SUITE 301
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4522
Practice Address - Country:US
Practice Address - Phone:480-657-8800
Practice Address - Fax:480-661-0149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZCD5745OtherRAILROAD MEDICARE
AZZWCKBWMedicare PIN