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General NPI Number Information
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NPI Number | 1093959744
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Entity Type | Individual
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Provider Name | JOSEPH S MACHUZAK D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2009
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Last Update Date | 03/20/2019
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Provider Practice Location Address
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Address Line | 3101 CLEARWATER DR STE C
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City | PRESCOTT
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State | AZ
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Zip | 86305
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Country | US
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Telephone | 928-202-4143
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Fax | 928-233-8917
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Provider Business Mailing Address
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Address Line | 7161 E RANCHO VISTA DR UNIT 3004
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-1655
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Country | US
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Telephone | 267-235-1023
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Fax | 928-233-8917
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 3753
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License Number State | AZ
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