Provider Demographics
NPI:1487238176
Name:ARIZONA VASCULAR SPECIALISTS, LLC
Entity type:Organization
Organization Name:ARIZONA VASCULAR SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:NAMANNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-777-4090
Mailing Address - Street 1:6442 E SPEEDWAY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-0012
Mailing Address - Country:US
Mailing Address - Phone:520-777-4090
Mailing Address - Fax:520-332-2941
Practice Address - Street 1:6442 E SPEEDWAY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1134
Practice Address - Country:US
Practice Address - Phone:520-777-4090
Practice Address - Fax:520-203-8795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-08
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty