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NPI Code Detail

MEDICARE: CHARLES ROUNDS PAC

MEDICARE: CHARLES ROUNDS PAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician3683AZ
22084A0401XAddiction Medicine (Psychiatry & Neurology) Physician3683AZ
3363AM0700XMedical Physician Assistant
42084P0800XPsychiatry Physician3683AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043400427
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES ROUNDS PAC
Provider Business Mailing Address
First Line : 15050 N 6TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85022-3615
Country : US
Telephone Number : 623-202-1199
Fax Number :
Provider Business Practice Location Address
First Line : 6151-6153 W OLIVE AVE
Second Line :
City : GLENDALE
State : AZ
Zip : 85302-4598
Country : US
Telephone Number : 602-685-6000
Fax Number : 602-389-3599
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2007
Last Update Date : 09/13/2019

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Directions to “ CHARLES ROUNDS PAC” Practice Location

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