Healthcare Provider Details
I. General information
NPI: 1285338343
Provider Name (Legal Business Name): HONORHEALTH MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2023
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5316 E SHEA BLVD STE 100
SCOTTSDALE AZ
85254-4717
US
IV. Provider business mailing address
2500 W UTOPIA RD
PHOENIX AZ
85027-4171
US
V. Phone/Fax
- Phone: 480-882-7420
- Fax:
- Phone: 689-683-7673
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
NEAL
Title or Position: EVP/CPE
Credential:
Phone: 623-683-7673