Mydockj
Family Medicine in Scottsdale, AZ. Organization (NPI-2).
NPI number1407129646
StatusActive
Last updated in NPPESFeb 20, 2012
Details
- NPI
- 1407129646
- Entity type
- Organization (NPI-2)
- Legal business name
- Mydockj
- Organization subpart
- No
- Enumeration date
- Feb 20, 2012
- Last updated
- Feb 20, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 19257 | AZ | Yes |
Practice location
8520 E Shea BlvdSte 105
Scottsdale, AZ 85260-6677
Phone 602-390-1509
Mailing address
10105 E Via LindaSte 103-364
Scottsdale, AZ 85258-5311
Phone 602-390-1509
Authorized official
Kim D Johnson
President
6023901509
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