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General NPI Number Information
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NPI Number | 1295535342
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Entity Type | Organization
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Legal Business Name | MEDPSYCHPLUS LLC
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 210 W CONTINENTAL RD STE 246A
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City | GREEN VALLEY
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State | AZ
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Zip | 85622-3596
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Country | US
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Telephone | 520-812-6200
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Fax | 833-672-2775
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Provider Business Mailing Address
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Address Line | 210 W CONTINENTAL RD STE 246A
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City | GREEN VALLEY
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State | AZ
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Zip | 85622-3596
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Country | US
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Telephone | 520-812-6200
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Fax | 833-672-2775
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JOHN SPARKS
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Credential | DNP
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Telephone | 520-812-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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