Healthcare Provider Details

I. General information

NPI: 1699759928
Provider Name (Legal Business Name): DAREK SOTT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 09/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4530 E MUIRWOOD DR #105
PHOENIX AZ
85048-7639
US

IV. Provider business mailing address

4530 E MUIRWOOD DR #105
PHOENIX AZ
85048-7639
US

V. Phone/Fax

Practice location:
  • Phone: 480-961-2303
  • Fax: 480-961-2306
Mailing address:
  • Phone: 480-961-2303
  • Fax: 480-961-2306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4430
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number3655
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: