| Scottsdale Medical Group Llc | |
|
4432 N Miller Rd Ste 102 Scottsdale AZ 85251-3697 | |
| (480) 306-7227 | |
| Not Available |
| Full Name | Scottsdale Medical Group Llc |
|---|---|
| Speciality | General Practice |
| Location | 4432 N Miller Rd Ste 102, Scottsdale, Arizona |
| Authorized Official Name and Position | Michael Cormier (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4803067227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scottsdale Medical Group Llc 4432 N Miller Rd Ste 102 Scottsdale AZ 85251-3697 Ph: (480) 306-7227 | Scottsdale Medical Group Llc 4432 N Miller Rd Ste 102 Scottsdale AZ 85251-3697 Ph: (480) 306-7227 |
| NPI Number | 1659847036 |
|---|---|
| Provider Enumeration Date | 10/23/2018 |
| Last Update Date | 02/12/2024 |
| Medicare PECOS PAC ID | 4385988823 |
|---|---|
| Medicare Enrollment ID | O20181210002683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659847036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Garrett Raymond Mack |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1700161775 PECOS PAC ID: 5890968820 Enrollment ID: I20111107000754 |
| Provider Name | Jeremy R Buckner |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1104805332 PECOS PAC ID: 7517129679 Enrollment ID: I20120507000693 |
| Provider Name | Thomas Wesley Schrimsher |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1700045960 PECOS PAC ID: 8022207448 Enrollment ID: I20191003002990 |
| Provider Name | Juan Vidales |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1023602406 PECOS PAC ID: 7810304573 Enrollment ID: I20210324001668 |
| Provider Name | Kathryn Brungard |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1245718931 PECOS PAC ID: 7113278649 Enrollment ID: I20230621001921 |
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