Healthcare Provider Details

I. General information

NPI: 1629408257
Provider Name (Legal Business Name): ATLANTIS MULTISPECIALTY GROUP AZ PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2013
Last Update Date: 01/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 E CONFERENCE DR
TEMPE AZ
85284-2604
US

IV. Provider business mailing address

PO BOX 14367
SCOTTSDALE AZ
85267-4367
US

V. Phone/Fax

Practice location:
  • Phone: 602-432-8813
  • Fax:
Mailing address:
  • Phone: 318-424-4008
  • Fax: 318-424-6606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID K TOWNS
Title or Position: MANAGING DIRECTOR
Credential: MD
Phone: 602-432-8813