SPORTSMEDICINE OUTREACH SPECIALIST NPI 1053898833

NPI Information

NPI: 1053898833
Provider Name: SPORTSMEDICINE OUTREACH SPECIALIST
Classification: Physician Assistant - 363AS0400X
Entity Type: Organization

Specialization: Surgical

Address:
13247 N 80TH PL
SCOTTSDALE, AZ
ZIP 85260
Phone: (602) 689-9588
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SPORTSMEDICINE OUTREACH SPECIALIST is a surgical physician assistant in Scottsdale, AZ. SPORTSMEDICINE OUTREACH SPECIALIST NPI is 1053898833. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

13247 N 80TH PL
SCOTTSDALE, AZ
ZIP 85260-903
Phone: (602) 689-9588

The provider's authorized official is Matthew Dean Overlin .
The authorized official title is Physician Assistant and has the following contact phone number (602) 689-9588.

The enumeration date for this NPI number is 7/24/2018 and was last updated on 7/24/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	3233	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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