Organization Active NPI

Arizona Urology Center, PLLC

  • Urology Physician
  • Sierra Vista, AZ
National Provider Identifier
1700069952
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
33318 Issued in AZ
Legal business name
ARIZONA UROLOGY CENTER, PLLC
Practice address
3410 Canyon de Flores
Suite B
Sierra Vista, AZ 85650-5372
Phone
(520) 803-0676
NPI assigned
Dec 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Authorized official

Name
Ann Wolk
Title
Office Manager
Phone
(520) 803-0676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 33318 AZ Primary

Addresses

Primary practice location

3410 Canyon de Flores
Suite B
Sierra Vista, AZ 85650-5372

Mailing address

3410 Canyon de Flores
Suite B
Sierra Vista, AZ 85650-5372
Phone (520) 803-0676

Other identifiers 1

IdentifierTypeStateIssuer
890790MedicaidAZ

National Provider Directory

National Provider Directory

Locations

3410 Canyon de Flores
Ste B
Sierra Vista, AZ 85650
Phone (520) 459-4477

3410 Canyon de Flores
Sierra Vista, AZ 85650
Phone (520) 459-4477

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1700069952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 CANYON DE FLORES",
            "address_2": "SUITE B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856505372",
            "telephone_number": "520-803-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 CANYON DE FLORES",
            "address_2": "SUITE B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856505372",
            "telephone_number": "520-803-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA UROLOGY CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "WOLK",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "520-803-0676"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "AZ",
            "license": "33318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890790",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; 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.