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BANNER PHYSICIAN SPECIALISTS ARIZONA LLC
NPI 1366799355
Clinic/Center - Multi-Specialty in Page, AZ

Active since August 08, 2012
601 N NAVAJO, PAGE, AZ 86040(928) 645-0131(928) 645-3549 Get Directions Write a Review

NPPES record last updated: December 29, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Banner Physician Specialists Arizona Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BANNER PHYSICIAN SPECIALISTS ARIZONA LLC (NPI 1366799355) is a healthcare organization registered as a multi-specialty in Page, Arizona and active in the NPI registry since August 2012. The organization lists Dennis Laraway, Cfo, as its authorized official.

NPPES Registry Identity

NPI1366799355
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameBANNER PHYSICIAN SPECIALISTS ARIZONA LLC
Location Address601 N NAVAJOPage, AZ 86040
Mailing Address2901 N Central Ave Ste 160Phoenix, AZ 85012-2702
Phone(928) 645-0131
Fax(928) 645-3549
Organization SubpartYesParent: Banner Medical Group Arizona
Authorized OfficialDennis LarawayCfo · (602) 747-4000
Enumeration DateAugust 8, 2012
Last NPPES UpdateDecember 29, 2021
NPPES CertifiedDecember 29, 2021
✔ NPI 1366799355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
601 N NAVAJO, Page, AZ 86040
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Other Identifiers 1

Medicaid646505AZ

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAGE HOSPITAL
Clinic/Center (Rural Health)
601 N NAVAJO
PAGE, AZ 86040
Coconino County (928) 645-0766
BANNER PRIMARY CARE PHYSICIANS ARIZONA LLC
Clinic/Center (Multi-Specialty)
601 N NAVAJO
PAGE, AZ 86040
Coconino County (928) 645-0740
PAGE HOSPITAL
Clinic/Center (Rural Health)
601 N NAVAJO
PAGE, AZ 86040
Coconino County (928) 645-0766

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Banner Physician Specialists Arizona LLC's NPI number?

The NPI number for Banner Physician Specialists Arizona LLC is 1366799355. It was assigned to this organization in the NPPES registry on August 8, 2012.

Where is Banner Physician Specialists Arizona LLC located?

Banner Physician Specialists Arizona LLC is located at 601 N Navajo, Page, AZ 86040. The listed phone number is (928) 645-0131.

What is Banner Physician Specialists Arizona LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Banner Physician Specialists Arizona LLC was last updated on December 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.