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General NPI Number Information
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NPI Number | 1336028588
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Entity Type | Organization
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Legal Business Name | DEKKER MEDICAL INDUSTRIAL PLLC
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Dates
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Enumeration Date | 09/01/2025
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Last Update Date | 10/02/2025
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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 | OWNER
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Name | DR. MICHAEL ALLEN DEKKER
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Credential | DO
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 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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