Healthcare Provider Details

I. General information

NPI: 1538699491
Provider Name (Legal Business Name): JTM HEALTHCARELLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12049 W INDIAN SCHOOL ROAD SUITE B210
AVONDALE AZ
85392-9505
US

IV. Provider business mailing address

PO BOX 11180
TEMPE AZ
85284-0020
US

V. Phone/Fax

Practice location:
  • Phone: 602-677-0187
  • Fax: 623-935-9925
Mailing address:
  • Phone: 602-677-0187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS A MORGAN
Title or Position: PRESIDENT
Credential: DC
Phone: 623-935-9920