MEDICARE: MOBILE DOCTORS, 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
1	207Q00000X	Family Medicine Physician	32339	AZ

General Provider Information

NPI Number	:	1467634386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE DOCTORS, LLC

Provider Business Mailing Address
First Line	:	1121 N 44TH ST
Second Line	:	STE 1043
City	:	PHOENIX
State	:	AZ
Zip	:	85008-5706
Country	:	US
Telephone Number	:	602-218-8542
Fax Number	:	602-670-5965

Provider Business Practice Location Address
First Line	:	1121 N 44TH ST
Second Line	:	STE 1043
City	:	PHOENIX
State	:	AZ
Zip	:	85008-5706
Country	:	US
Telephone Number	:	602-218-8542
Fax Number	:	602-670-5965

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROGER OLADE
Credential	:	MD
Telephone Number	:	602-218-8542

Provider Enumeration Date	:	12/03/2007
Last Update Date	:	03/07/2023

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