Banner Physician Specialists Arizona LLC

NPI #1326710906 in Peoria, Arizona

Provider Information

NPI Number: 1326710906
Entity Type: Organization
Organization Name: Banner Physician Specialists Arizona LLC
Subpart: Yes (part of a larger organization)
Parent Organization: BANNER MEDICAL GROUP
Primary Specialty: Nutritionist - Nutrition, Education
Enumeration Date: Oct 1, 2021
Last Updated: Dec 29, 2021

Practice Location

Address: 9165 W THUNDERBIRD RD
City: Peoria
State: Arizona
ZIP Code: 85381-4847
Phone: (623) 285-1120

Authorized Official

Name: DENNIS LARAWAY
Title: CHIEF FINANCIAL OFFICER
Phone: (602) 747-4000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Multi-Specialty — Multi-Specialty	261QM1300X
Nutritionist - Nutrition, Education — Nutrition, Education	133NN1002X	Primary

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