Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Banner -- University Medical Center Phoenix Campus Family Medicine

Organization Family Medicine Physician · NPI 1124073747

Banner -- University Medical Center Phoenix Campus Family Medicine is a Family Medicine Physician in Phoenix, Arizona. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

1300 N 12th St Ste 605
Phoenix, AZ 85006-2848
Phone: (602) 239-4567
Fax: (602) 239-2067
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1124073747
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationBanner Health
Authorized official Dennis Dahlen — Sr Vice President - Finance · (602) 747-4000
NPI enumeratedMay 23, 2006
Last updated in NPPESFebruary 26, 2015
Mailing address1441 N 12th St, Phoenix, AZ 85006-2837

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