CREOSOTE TOTAL HEALTH PC NPI 1043928476

NPI Information

  • NPI: 1043928476
  • Provider Name: CREOSOTE TOTAL HEALTH PC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: CREOSOTE TOTAL HEALTH
  • CLIA Number: 03D2303638
  • Address: 8380 S KYRENE RD # D-103
    TEMPE, AZ
    ZIP 85284
  • Phone: (480) 269-3208

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NPI Details

CREOSOTE TOTAL HEALTH PC is a family medicine in Tempe, AZ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CREOSOTE TOTAL HEALTH PC NPI is 1043928476. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Creosote Total Health.

The provider's business location address is:

8380 S KYRENE RD # D-103
TEMPE, AZ
ZIP 85284-120
Phone: (480) 269-3208
Fax: (480) 674-1295

The provider's authorized official is Simon Sheard .
The authorized official title is Physician/owner and has the following contact phone number (480) 269-3208.

The CLIA number assigned to this NPI record is 03D2303638 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/15/2022 and was last updated on 4/17/2024.

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
1207Q00000XFamily MedicineYes

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: 3/30/2025

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