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General NPI Number Information
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NPI Number | 1952108342
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Entity Type | Organization
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Legal Business Name | RHODIUM MEDICAL OF ARIZONA LLC
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 1327 W SAN PEDRO ST
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City | GILBERT
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State | AZ
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Zip | 85233-2403
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Country | US
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Telephone | 702-659-5604
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Fax | 702-660-6186
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Provider Business Mailing Address
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Address Line | 1000 N GREEN VALLEY PKWY # 440-127
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City | HENDERSON
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State | NV
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Zip | 89074-6170
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Country | US
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Telephone | 702-659-5604
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Fax | 702-660-6186
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Authorized Official
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Title or Position | OWNER
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Name | CRAIG JORGENSON
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Credential | MD
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Telephone | 702-659-5604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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