Healthcare Provider Details

I. General information

NPI: 1982750600
Provider Name (Legal Business Name): FORTY-THIRD MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 12/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7725 N 43RD AVE #111
PHOENIX AZ
85051
US

IV. Provider business mailing address

7725 N 43RD AVE #111
PHOENIX AZ
85051
US

V. Phone/Fax

Practice location:
  • Phone: 623-931-9201
  • Fax: 623-931-2116
Mailing address:
  • Phone: 623-931-9201
  • Fax: 623-931-2116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES L. BEACH
Title or Position: OWNER
Credential: D.O.
Phone: 623-463-8533