Healthcare Provider Details

I. General information

NPI: 1548778715
Provider Name (Legal Business Name): CHRISTOPHER RYAN MCGEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2018
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 N 12TH ST FL 2
PHOENIX AZ
85006-2837
US

IV. Provider business mailing address

1441 N 12TH ST FL 2
PHOENIX AZ
85006-2837
US

V. Phone/Fax

Practice location:
  • Phone: 602-521-5969
  • Fax:
Mailing address:
  • Phone: 602-521-5969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberR82392
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number0101267692
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number0101267692
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: