Provider Demographics
NPI:1619869278
Name:ARIZONA CARDIAC SPECIALISTS PLLC
Entity type:Organization
Organization Name:ARIZONA CARDIAC SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:JETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-583-2073
Mailing Address - Street 1:11124 W CALIFORNIA AVE STE G
Mailing Address - Street 2:
Mailing Address - City:YOUNGTOWN
Mailing Address - State:AZ
Mailing Address - Zip Code:85363-1246
Mailing Address - Country:US
Mailing Address - Phone:623-583-2073
Mailing Address - Fax:
Practice Address - Street 1:10401 W THUNDERBIRD BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3004
Practice Address - Country:US
Practice Address - Phone:623-832-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIZONA CARDIAC SPECIALISTS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty