CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC NPI 1326585662

NPI Information

CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC is an addiction medicine internal medicine in Phoenix, AZ. The provider is 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 NPI is 1326585662. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

8410 W THOMAS
PHOENIX, AZ
ZIP 85037
Phone: (413) 584-2173

The provider's authorized official is Robert Hutchison .
The authorized official title is Cfo and has the following contact phone number (615) 425-0220.

The CLIA number assigned to this NPI record is 22D2179494 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/25/2017 and was last updated on 7/2/2019.

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:

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