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 |
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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 |
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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 |
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Provider Enumeration Date | 10/23/2018 |
Last Update Date | 02/12/2024 |
Medicare PECOS PAC ID | 4385988823 |
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Medicare Enrollment ID | O20181210002683 |
Identifier | Type | State | Issuer |
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1659847036 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Michael D Cormier |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1851499057 PECOS PAC ID: 6901879824 Enrollment ID: I20040823001155 |
Provider Name | Jeremy R Buckner |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1104805332 PECOS PAC ID: 7517129679 Enrollment ID: I20120507000693 |
Provider Name | Kathryn Brungard |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1245718931 PECOS PAC ID: 7113278649 Enrollment ID: I20230621001921 |
Provider Name | Benjamin King |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1114568045 PECOS PAC ID: 7911330535 Enrollment ID: I20240415001186 |
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