Graduated: 2012
NPI: 1942543749
Practice Locations (2)
BANNER PHYSICIAN SPECIALISTS ARIZONA LLC
122 E MAIN ST
PAYSON, AZ 855415574
9285964600
SJHMC PHYSICIAN SERVICES
625 N 6TH ST
PHOENIX, AZ 850042155
6024068222
Source: CMS National Downloadable File, September 2026.