AT DIRECT SPORTS MEDICINE LLC NPI 1720507262

NPI Information

NPI: 1720507262
Provider Name: AT DIRECT SPORTS MEDICINE, LLC
Classification: Preventive Medicine - 2083S0010X
Entity Type: Organization

Specialization: Sports Medicine

Address:
6424 E FAIRFIELD ST
MESA, AZ
ZIP 85205
Phone: (520) 235-0067
Get Directions

AT DIRECT SPORTS MEDICINE, LLC is a sports medicine preventive medicine in Mesa, AZ. The provider is a preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. AT DIRECT SPORTS MEDICINE, LLC NPI is 1720507262. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6424 E FAIRFIELD ST
MESA, AZ
ZIP 85205-042
Phone: (520) 235-0067

The provider's authorized official is Casey Erickson .
The authorized official title is Owner/athletic Trainer and has the following contact phone number (520) 235-0067.

The enumeration date for this NPI number is 9/15/2017 and was last updated on 9/15/2017.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2083S0010X	Preventive Medicine	Sports Medicine	1318	ARIZONA	Yes

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: 11/14/2023

NPI Synchronization or Removal

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