NPI Code Details Logo

NPI 1699614362

NPI 1699614362 : SPECTRAL HEALTH, PLLC : PHOENIX, AZ

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1699614362
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    SPECTRAL HEALTH, PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/26/2026
-----------------------------------------------------
    Last Update Date     |    03/26/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1950 E WATKINS ST STE 125 
-----------------------------------------------------
    City                 |    PHOENIX
-----------------------------------------------------
    State                |    AZ
-----------------------------------------------------
    Zip                  |    85034-5712
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    855-495-4584
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    5348 VEGAS DR # 1440 
-----------------------------------------------------
    City                 |    LAS VEGAS
-----------------------------------------------------
    State                |    NV
-----------------------------------------------------
    Zip                  |    89108-2347
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    MANAGER
-----------------------------------------------------
    Name                 |     FRANKLIN  MOSES 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    240-245-0889
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207QG0300X
-----------------------------------------------------
    Taxonomy Name        |    Geriatric Medicine (Family Medicine) Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    207RG0300X
-----------------------------------------------------
    Taxonomy Name        |    Geriatric Medicine (Internal Medicine) Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    207Q00000X
-----------------------------------------------------
    Taxonomy Name        |    Family Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.