Healthcare Provider Details

I. General information

NPI: 1871525634
Provider Name (Legal Business Name): THOMAS E MASTERS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 01/17/2020
Certification Date: 01/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 N TREKELL RD STE A3
CASA GRANDE AZ
85122-1705
US

IV. Provider business mailing address

1821 N TREKELL RD STE A3
CASA GRANDE AZ
85122-1705
US

V. Phone/Fax

Practice location:
  • Phone: 520-421-0986
  • Fax: 520-421-2009
Mailing address:
  • Phone: 520-421-0986
  • Fax: 520-421-2009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number2951
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number2951
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number2951
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: