Healthcare Provider Details
I. General information
NPI: 1376306522
Provider Name (Legal Business Name): HONORHEALTH MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/31/2024
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4902 E SHEA BLVD STE 101
SCOTTSDALE AZ
85254-4184
US
IV. Provider business mailing address
2500 W UTOPIA RD
PHOENIX AZ
85027-4171
US
V. Phone/Fax
- Phone: 623-683-1000
- Fax:
- Phone: 623-683-1000
- 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
NEIL
Title or Position: CMO
Credential:
Phone: 480-587-5123