Organization Name: | ATLANTIS MEDICAL SPECIALIST AZ, PLLC |
NPI Number: | 1982954996 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID K TOWNS (OWNER) |
Mailing Address: | 11124 W California Ave Ste G Youngtown |
State: | AZ US |
Postal Code: | 853631246 |
Phone Number: | 6235832073 |
Fax Number: | 6235831099 |
NPI Enumeration Date: | 09/17/2012 |
NPI Last Update Date: | 09/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |