RICHARD LEE AVERITTE JR. PLLC NPI 1619428851

NPI Information

RICHARD LEE AVERITTE JR., PLLC is a non pharmacy dispensing site in Anthem, AZ. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) RICHARD LEE AVERITTE JR., PLLC NPI is 1619428851. The provider is registered as an organization entity type.
The provider Is Doing Business As Affiliated Dermatology.

The provider's business location address is:

41810 N VENTURE DR
SUITE D136
ANTHEM, AZ
ZIP 85086-169
Phone: (480) 556-0446
Fax: (480) 223-6850

The provider's authorized official is Marlie Averitte .
The authorized official title is Cfo and has the following contact phone number (480) 556-0446.

The CLIA number assigned to this NPI record is 03D2051762 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/24/2016 and was last updated on 10/24/2016.

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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