Banner -- University Medical Center Phoenix Campus Liver Disease Servi

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS LIVER DISEASE SERVI

Practice address

2771 Silver Creek Rd
Suite 101
Bullhead City, AZ 86442-7959

Phone

(602) 839-4123

NPI assigned

Sep 16, 2010

Organization subpart

Yes

Parent organization

BANNER HEALTHAs reported in NPPES

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

Authorized official

Name

Dennis E Dahlen

Title

Sr VP Finance

Phone

(602) 747-4000

Specialties & licenses 1

Addresses

Part of

M E Lee MD

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1306154943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 SILVER CREEK RD",
            "address_2": "SUITE 101",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427959",
            "telephone_number": "602-839-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS LIVER DISEASE SERVI",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2010-09-16",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SR VP FINANCE",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freeha Afshin Azher, MD
• Abdul Aziz, MD
• Dwaynie Bacon Jr.
• Paige Theresa Bafus, DDS
• Richard Lefroy Bailey, M.D.
• Amy G Barnard, NP
• Philip Charles Barnard, D.C.
• Amber Ann Barnes, NP-C
• Sheila Marie Barnett, RDH, DC
• Bashir Ahmed Azher PC

• Multi-Specialty Clinic/Center in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Multi-Specialty Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.