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NPI Code Detail

MEDICARE: ARIZONA SPORTS MEDICINE CONSULTANTS PC

MEDICARE: ARIZONA SPORTS MEDICINE CONSULTANTS PC
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
12080S0010XPediatric Sports Medicine Physician24720AZ

General Provider Information

NPI Number : 1760696025
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARIZONA SPORTS MEDICINE CONSULTANTS PC
Provider Business Mailing Address
First Line : 4530 N 32ND ST
Second Line : # 102
City : PHOENIX
State : AZ
Zip : 85018
Country : US
Telephone Number : 602-493-1626
Fax Number : 602-218-6872
Provider Business Practice Location Address
First Line : 4530 N 32ND ST
Second Line : # 102
City : PHOENIX
State : AZ
Zip : 85018
Country : US
Telephone Number : 602-493-1626
Fax Number : 602-218-6872
Authorized Official
Title or Position : VICE PRESIDENT
Name : DAVID CHRISTIAN CHAPMAN
Credential : MD MS
Telephone Number : 602-493-1626
Provider Enumeration Date : 05/09/2007
Last Update Date : 08/22/2020

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