Healthcare Provider Details
I. General information
NPI: 1811749443
Provider Name (Legal Business Name): BASELINE PSYCHIATRY PLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/05/2024
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16421 N TATUM BLVD STE 203
PHOENIX AZ
85032-3457
US
IV. Provider business mailing address
16421 N TATUM BLVD STE 203
PHOENIX AZ
85032-3457
US
V. Phone/Fax
- Phone: 602-345-0466
- Fax: 727-245-0166
- Phone: 602-345-0466
- Fax: 727-245-0166
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSHUA
M
HILTON
Title or Position: PMHNP
Credential:
Phone: 480-234-3626