Az Private MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

AZ PRIVATE MD LLC

Practice address

5220 N Dysart Rd
Suite 172
Litchfield Park, AZ 85340-3045

Phone

(623) 695-9789

NPI assigned

Jul 30, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian G Hawkins, MD

Title

Owner/Member

Phone

(623) 695-9789

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1023494192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20490",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852770490",
            "telephone_number": "480-985-1093",
            "fax_number": "480-296-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 N DYSART RD",
            "address_2": "SUITE 172",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403045",
            "telephone_number": "623-695-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ PRIVATE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "623-695-9789",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.