Healthcare Provider Details

I. General information

NPI: 1629935457
Provider Name (Legal Business Name): ACUMEN MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 N CENTRAL AVE STE D160
PHOENIX AZ
85012-2652
US

IV. Provider business mailing address

3110 N CENTRAL AVE STE D160
PHOENIX AZ
85012-2652
US

V. Phone/Fax

Practice location:
  • Phone: 480-915-2288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARLO ANTONE WATKINS
Title or Position: OWNER
Credential:
Phone: 480-915-2288