Healthcare Provider Details
I. General information
NPI: 1912675463
Provider Name (Legal Business Name): COMPTON MEDICAL CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2021
Last Update Date: 05/04/2025
Certification Date: 05/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1757 E BASELINE RD STE 105
GILBERT AZ
85233-1533
US
IV. Provider business mailing address
70 S VAL VISTA DR STE A3-646
GILBERT AZ
85296-1374
US
V. Phone/Fax
- Phone: 480-508-2700
- Fax: 866-371-2839
- Phone: 480-508-2700
- Fax: 866-371-2839
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WR0006X |
| Taxonomy | Registered Nurse First Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
COMPTON
Title or Position: DOCTOR/OWNER
Credential: DC, FNP-C, MSN, RNFA
Phone: 480-508-2700