| Healthspanmd Pllc | |
|
2222 E Highland Ave Ste 222 Phoenix AZ 85016-4876 | |
| (480) 847-2575 | |
| Not Available |
| Full Name | Healthspanmd Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2222 E Highland Ave Ste 222, Phoenix, Arizona |
| Authorized Official Name and Position | Robert Todd Hurst (OWNER) |
| Authorized Official Contact | 4808472575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthspanmd Pllc 4808 N 24th St Unit 1103 Phoenix AZ 85016-9113 Ph: (480) 847-2575 | Healthspanmd Pllc 2222 E Highland Ave Ste 222 Phoenix AZ 85016-4876 Ph: (480) 847-2575 |
| NPI Number | 1548984800 |
|---|---|
| Provider Enumeration Date | 09/30/2022 |
| Last Update Date | 12/20/2023 |
| Medicare PECOS PAC ID | 4183091291 |
|---|---|
| Medicare Enrollment ID | O20221102002292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548984800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Secondary |
| Provider Name | Lisa M Hurst |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417930132 PECOS PAC ID: 3678596863 Enrollment ID: I20060113000609 |
| Provider Name | Sylvia A Mamby |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700860897 PECOS PAC ID: 0648313197 Enrollment ID: I20100205000115 |
| Provider Name | Robert T Hurst |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124000989 PECOS PAC ID: 3476684309 Enrollment ID: I20100621000921 |
| Provider Name | Brandy Anne Compton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265165476 PECOS PAC ID: 2466825666 Enrollment ID: I20230309001919 |
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