CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC – NPI #1326585662
Internal Medicine

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.

CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC is a provider located in PHOENIX, AZ. NPPES has assigned the NPI number 1326585662 to CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC on January 25, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207RA0401X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Addiction Medicine

The NPI profile was previously updated about 7 years ago on Jul 02, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC below.

NPI Profile for
CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC

NPI Number
1326585662
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC
Primary location
8410 W THOMAS
PHOENIX, AZ 85037
Phone: (413) 584-2173 Fax:
Mailing address
15 CENTURY BLVD STE 307
NASHVILLE, TN 37214-3692
Phone: (615) 425-0220 Fax:
Organization Subpart
No
Authorized Official
ROBERT HUTCHISON
CFO
Phone: (615) 425-0220
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RA0401X
- Internal Medicine / Addiction Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.