Healthcare Provider Details

I. General information

NPI: 1164959441
Provider Name (Legal Business Name): ROBERT DANIEL CLAFLIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 E MCKELLIPS RD BLDG 2
MESA AZ
85203
US

IV. Provider business mailing address

840 E MCKELLIPS RD BLDG 2
MESA AZ
85203-9645
US

V. Phone/Fax

Practice location:
  • Phone: 602-491-0703
  • Fax:
Mailing address:
  • Phone: 602-491-0703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number009099
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number009099
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: