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NPI 1023992518

NPI 1023992518 : DEKKER MEDICAL INDUSTRIAL : SCOTTSDALE, AZ

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General NPI Number Information
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    NPI Number           |    1023992518
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    Entity Type          |    Organization 
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    Legal Business Name  |    DEKKER MEDICAL INDUSTRIAL 
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Dates
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    Enumeration Date     |    08/05/2025
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    Last Update Date     |    08/05/2025
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Provider Practice Location Address
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    Address Line         |    14256 N NORTHSIGHT BLVD STE 110 
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    City                 |    SCOTTSDALE
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    State                |    AZ
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    Zip                  |    85260-3954
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    Country              |    US
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    Telephone            |    480-561-0141
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    Fax                  |    602-429-8447
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Provider Business Mailing Address
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    Address Line         |    1923 E HAZELWOOD ST 
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    City                 |    PHOENIX
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    State                |    AZ
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    Zip                  |    85016-4614
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    Country              |    US
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    Telephone            |    954-319-8579
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    Fax                  |    602-429-8447
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Authorized Official
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    Title or Position    |    ADDICTION PSYCHIATRIST
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    Name                 |    DR. MICHAEL A DEKKER 
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    Credential           |    D.O.
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    Telephone            |    954-319-8579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2084P0802X
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    Taxonomy Name        |    Addiction Psychiatry Physician
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    
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    License Number State |    
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