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NPI Code Detail

MEDICARE: CHANDLER EMERGENCY MEDICAL GROUP, LLC

MEDICARE: CHANDLER EMERGENCY MEDICAL GROUP, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1104871961
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHANDLER EMERGENCY MEDICAL GROUP, LLC
Provider Business Mailing Address
First Line : PO BOX 99127
Second Line :
City : LAS VEGAS
State : NV
Zip : 89193-9127
Country : US
Telephone Number : 954-939-5000
Fax Number : 877-250-6889
Provider Business Practice Location Address
First Line : 1955 W FRYE RD
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-6282
Country : US
Telephone Number : 954-939-5000
Fax Number : 877-250-6889
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : CHRISTOPHER KENNEDY
Credential :
Telephone Number : 484-213-2395
Provider Enumeration Date : 05/23/2006
Last Update Date : 01/29/2026

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