Healthcare Provider Details

I. General information

NPI: 1508041484
Provider Name (Legal Business Name): ACUTE CARE SPECIALIST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 W THUNDERBIRD BLVD
SUN CITY AZ
85351-3004
US

IV. Provider business mailing address

4410 W. UNION HILLS # 7, PMB 280
GLENDALE AZ
85308-1169
US

V. Phone/Fax

Practice location:
  • Phone: 623-974-6611
  • Fax: 623-974-9434
Mailing address:
  • Phone: 623-974-6611
  • Fax: 623-974-9434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number19206
License Number StateAZ

VIII. Authorized Official

Name: JOHN W WAKELY
Title or Position: MD, OWNER
Credential: M.D.
Phone: 602-448-6131