| Organization Name: | HEART INSTITUTE OF NORTHERN ARIZONA LLC |
| NPI Number: | 1013189893 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | A PAUL KALANITHI (MEDICAL DIRECTOR) |
| Mailing Address: | 1753 Airway Ave Suite B Kingman |
| State: | AZ US |
| Postal Code: | 864093720 |
| Phone Number: | 9286926200 |
| Fax Number: | 9286929474 |
| NPI Enumeration Date: | 04/01/2008 |
| NPI Last Update Date: | 04/27/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | OTC710 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |