Provider Demographics
NPI:1528051620
Name:GREATER ARIZONA GASTROENTEROLOGY & ASSOCIATES PC
Entity type:Organization
Organization Name:GREATER ARIZONA GASTROENTEROLOGY & ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NADEEM
Authorized Official - Middle Name:A
Authorized Official - Last Name:KAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-426-1928
Mailing Address - Street 1:1780 E FLORENCE BLVD
Mailing Address - Street 2:#104
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-4782
Mailing Address - Country:US
Mailing Address - Phone:520-426-1928
Mailing Address - Fax:520-426-9088
Practice Address - Street 1:1780 E FLORENCE BLVD
Practice Address - Street 2:#104
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-4782
Practice Address - Country:US
Practice Address - Phone:520-426-1928
Practice Address - Fax:520-426-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25728207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0810620OtherBCBS
628670OtherANTHEM BLUE CROSS
PIM21KAZINA1OtherMERCYCAREPLAN PREMIUM
AZ1Z0212OtherHEALTHNET
AZ393968Medicaid
95964OtherPACIFICARE HMO
601101OtherHUMANA
95999OtherPACIFICARE PPO
1002828OtherAETNA
7612839OtherDIVISION OF MEDICAL ASST
1002828OtherAETNA
628670OtherANTHEM BLUE CROSS
AZZ20284Medicare ID - Type Unspecified