Healthcare Provider Details

I. General information

NPI: 1699614362
Provider Name (Legal Business Name): SPECTRAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 E WATKINS ST STE 125
PHOENIX AZ
85034-5712
US

IV. Provider business mailing address

5348 VEGAS DR # 1440
LAS VEGAS NV
89108-2347
US

V. Phone/Fax

Practice location:
  • Phone: 855-495-4584
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANKLIN MOSES
Title or Position: MANAGER
Credential:
Phone: 240-245-0889