Healthcare Provider Details

I. General information

NPI: 1245659432
Provider Name (Legal Business Name): ENGLISH DERMATOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15215 S 48TH ST SUITE 120
PHOENIX AZ
85044-9142
US

IV. Provider business mailing address

2285 CORPORATE CIR STE 200
HENDERSON NV
89074-7759
US

V. Phone/Fax

Practice location:
  • Phone: 480-706-6580
  • Fax: 480-706-8157
Mailing address:
  • Phone: 702-716-0291
  • Fax: 949-783-2880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number19375
License Number StateAZ

VIII. Authorized Official

Name: DR. PAUL E ENGLISH
Title or Position: CEO OWNER
Credential: M.D.
Phone: 480-706-6580