Provider Demographics
NPI: | 1861176166 |
---|---|
Name: | NORTHERN ARIZONA HEALTHCARE CORPORATION |
Entity type: | Organization |
Organization Name: | NORTHERN ARIZONA HEALTHCARE CORPORATION |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF OPERATING OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ROBERT |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | COFIELD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 928-773-2010 |
Mailing Address - Street 1: | 1200 N BEAVER ST |
Mailing Address - Street 2: | |
Mailing Address - City: | FLAGSTAFF |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 86001-3118 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 928-213-6527 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 269 S CANDY LN STE 2C |
Practice Address - Street 2: | |
Practice Address - City: | COTTONWOOD |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 86326-4158 |
Practice Address - Country: | US |
Practice Address - Phone: | 928-634-1331 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | NORTHERN ARIZONA HEALTHCARE CORPORATION |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2023-06-15 |
Last Update Date: | 2025-04-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
No | 207PH0002X | Allopathic & Osteopathic Physicians | Emergency Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RC0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | Group - Multi-Specialty |
No | 207RC0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | Group - Multi-Specialty |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207RH0002X | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
No | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | Group - Multi-Specialty |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty |