Healthcare Provider Details

I. General information

NPI: 1194741371
Provider Name (Legal Business Name): ANDREW HILL MEBANE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 N CENTRAL AVE STE 1050
PHOENIX AZ
85004-1217
US

IV. Provider business mailing address

7500 E MCCORMICK PKWY LOT 49
SCOTTSDALE AZ
85258-2913
US

V. Phone/Fax

Practice location:
  • Phone: 602-266-8402
  • Fax:
Mailing address:
  • Phone: 602-266-8402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG37395
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number37971
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: