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General NPI Number Information
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NPI Number | 1215794094
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Entity Type | Organization
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Legal Business Name | HEELEX 2 LLC
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 12329 W. BOLA DRIVE
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City | SURPRISE
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State | AZ
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Zip | 85378
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Country | US
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Telephone | 865-999-5898
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Fax |
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Provider Business Mailing Address
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Address Line | 12329 W. BOLA DRIVE
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City | SURPRISE
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State | AZ
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Zip | 85378
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD, OWNER
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Name | TODD JEFFERSON SCARBROUGH
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Credential | MD
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Telephone | 865-999-5898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine 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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number |
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License Number State |
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