Healthcare Provider Details

I. General information

NPI: 1730112830
Provider Name (Legal Business Name): EMPOWER EMERGENCY PHYSICIANS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W THOMAS RD ST. JOSEPH'S HOSPITAL & MEDICAL CENTER, EMERGENCY DEPT.
PHOENIX AZ
85013-4409
US

IV. Provider business mailing address

14818 N 74TH STREET
SCOTTSDALE AZ
85260
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-3361
  • Fax: 602-406-7165
Mailing address:
  • Phone: 480-339-5088
  • Fax: 480-452-0823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN JOSEPH SHUFELDT JR.
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 480-221-8059