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General NPI Number Information
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NPI Number | 1548984800
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Entity Type | Organization
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Legal Business Name | HEALTHSPANMD PLLC
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Dates
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Enumeration Date | 09/30/2022
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 2222 E HIGHLAND AVE STE 222
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City | PHOENIX
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State | AZ
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Zip | 85016-4876
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Country | US
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Telephone | 480-847-2575
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Fax |
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Provider Business Mailing Address
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Address Line | 4808 N 24TH ST UNIT 1103
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City | PHOENIX
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State | AZ
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Zip | 85016-9113
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Country | US
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Telephone | 480-847-2575
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT TODD HURST
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Credential | MD
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Telephone | 480-847-2575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease 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 | 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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