Provider Demographics
NPI:1548249766
Name:HAZELRIGG, ERIC SHAWN (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:SHAWN
Last Name:HAZELRIGG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 E PECOS RD STE 235
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-3207
Mailing Address - Country:US
Mailing Address - Phone:480-813-0944
Mailing Address - Fax:480-813-0038
Practice Address - Street 1:1760 E PECOS RD STE 235
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-3207
Practice Address - Country:US
Practice Address - Phone:480-813-0944
Practice Address - Fax:480-813-0038
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20772207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ99081OtherPACIFICARE
AZ1Z1555OtherHEALTHNET
AZ3336256OtherCIGNA
AZ0700208OtherUNITED HEALTHCARE
AZ163684Medicaid
AZ49453OtherMAYO HEALTH PLAN
AS2008183OtherAETNA
AZAZ0874980OtherBLUE CROSS BLUE SHIELD
AZPOB13HAZEER1Medicaid
AZ99081OtherPACIFICARE
AZ49453OtherMAYO HEALTH PLAN