Provider Demographics
NPI: | 1972648087 |
---|---|
Name: | ARIZONA HEART INSTITUTE LTD |
Entity type: | Organization |
Organization Name: | ARIZONA HEART INSTITUTE LTD |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ELECTROPHYSIOLOGY |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | MARK |
Authorized Official - Middle Name: | JOEL |
Authorized Official - Last Name: | SEIFERT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 602-266-2200 |
Mailing Address - Street 1: | 2632 N 20TH ST |
Mailing Address - Street 2: | |
Mailing Address - City: | PHOENIX |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85006-1339 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 602-266-2200 |
Mailing Address - Fax: | 602-604-5045 |
Practice Address - Street 1: | 2632 N 20TH ST |
Practice Address - Street 2: | |
Practice Address - City: | PHOENIX |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85006-1339 |
Practice Address - Country: | US |
Practice Address - Phone: | 602-266-2200 |
Practice Address - Fax: | 602-604-5045 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-02-20 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AZ | 33429 | 174400000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 174400000X | Other Service Providers | Specialist | Group - Single Specialty |