MARICOPA OBGYN NPI 1710198783

NPI Information

  • NPI: 1710198783
  • Provider Name: MARICOPA OBGYN
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 03D0863720
  • Address: 1661 E CAMELBACK RD
    SUITE 160
    PHOENIX, AZ
    ZIP 85016
  • Phone: (602) 241-1674

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NPI Details

MARICOPA OBGYN is a specialist in Phoenix, AZ. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MARICOPA OBGYN NPI is 1710198783. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1661 E CAMELBACK RD
SUITE 160
PHOENIX, AZ
ZIP 85016-911
Phone: (602) 241-1674
Fax: (602) 230-7982

The provider's authorized official is Tracianne Johnson .
The authorized official title is Hipaa Officer and has the following contact phone number (623) 551-0192.

The CLIA number assigned to this NPI record is 03D0863720 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/24/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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