Healthcare Provider Details

I. General information

NPI: 1154259117
Provider Name (Legal Business Name): SWITZER MEDICAL AZ, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4539 N 22ND ST STE R
PHOENIX AZ
85016-4639
US

IV. Provider business mailing address

41 E 400 N # 332
LOGAN UT
84321-4020
US

V. Phone/Fax

Practice location:
  • Phone: 385-340-3130
  • Fax:
Mailing address:
  • Phone: 435-640-6290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JUSTEN GREGORY WATKINS
Title or Position: OWNER
Credential: DO
Phone: 435-640-6290