Healthcare Provider Details
I. General information
NPI: 1629424379
Provider Name (Legal Business Name): MOBILEONEDOCS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2016
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10115 E BELL RD #107-234
SCOTTSDALE AZ
85260-2189
US
IV. Provider business mailing address
10115 E BELL RD #107-234
SCOTTSDALE AZ
85260-2189
US
V. Phone/Fax
- Phone: 888-709-8721
- Fax: 888-709-8721
- Phone: 888-709-8721
- Fax: 888-709-8721
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LISA
ANN
SWANSEN
Title or Position: PRESIDEN
Credential:
Phone: 480-843-9877