Healthcare Provider Details

I. General information

NPI: 1043253883
Provider Name (Legal Business Name): SOUTHWEST PHOENIX URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5920 W MCDOWELL RD
PHOENIX AZ
85035-4853
US

IV. Provider business mailing address

1710 THISTLE RD
FLAGSTAFF AZ
86004-7739
US

V. Phone/Fax

Practice location:
  • Phone: 480-776-1588
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN SHUFELDT
Title or Position: CEO
Credential: M. D.
Phone: 480-924-8382