Provider Demographics
NPI:1447344908
Name:ARIZONA TRANSPLANT ASSOCIATES, PC
Entity type:Organization
Organization Name:ARIZONA TRANSPLANT ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-252-2543
Mailing Address - Street 1:2218 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1401
Mailing Address - Country:US
Mailing Address - Phone:602-252-2543
Mailing Address - Fax:602-252-3861
Practice Address - Street 1:2218 N 3RD ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1401
Practice Address - Country:US
Practice Address - Phone:602-252-2543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ71339Medicare PIN