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VITALITY INTERNAL MEDICINE - AVONDALE PLLC NPI 1194212977


NPI Information

NPI: 1194212977
Provider Name: VITALITY INTERNAL MEDICINE - AVONDALE PLLC

Other Name: MEN'S VITALITY CENTER

Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
10320 W MCDOWELL RD STE E5015
AVONDALE, AZ
ZIP 85392
Phone: (602) 791-9112
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VITALITY INTERNAL MEDICINE - AVONDALE PLLC is an internal medicine in Avondale, AZ. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. VITALITY INTERNAL MEDICINE - AVONDALE PLLC NPI is 1194212977. The provider is registered as an organization entity type.
The provider Other Name Is Men's Vitality Center.

The provider's business location address is:

10320 W MCDOWELL RD STE E5015
AVONDALE, AZ
ZIP 85392-869
Phone: (602) 791-9112

The provider's authorized official is Charles Benjamin Evans .
The authorized official title is Medical Director and has the following contact phone number (602) 791-9112.

The enumeration date for this NPI number is 4/17/2018 and was last updated on 3/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QP2300XClinic/CenterPrimary CareNo
2207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
137616OTHERARIZONAMEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.