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General NPI Number Information
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NPI Number | 1508041484
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Entity Type | Organization
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Legal Business Name | ACUTE CARE SPECIALIST, LLC
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10401 W THUNDERBIRD BLVD
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City | SUN CITY
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State | AZ
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Zip | 85351-3004
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Country | US
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Telephone | 623-974-6611
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Fax | 623-974-9434
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Provider Business Mailing Address
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Address Line | 4410 W. UNION HILLS # 7, PMB 280
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City | GLENDALE
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State | AZ
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Zip | 85308-1169
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Country | US
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Telephone | 623-974-6611
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Fax | 623-974-9434
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Authorized Official
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Title or Position | MD, OWNER
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Name | JOHN W WAKELY
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Credential | M.D.
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Telephone | 602-448-6131
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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 | 19206
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License Number State | AZ
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