# CREOSOTE TOTAL HEALTH PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Creosote Total Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043928476
- **Authorized official:** DR. SIMON SHEARD DO (PHYSICIAN/OWNER)
- **Authorized official phone:** (480) 269-3208

## Contact information

- **Practice address:** 8380 S KYRENE RD \# D-103, TEMPE, AZ 85284-2120
- **Practice address phone:** (480) 269-3208
- **Practice address fax:** (480) 674-1295
- **Mailing address:** 8380 S KYRENE RD \# D-103, TEMPE, AZ 85284-2120
- **Mailing address phone:** (480) 269-3208
- **Mailing address fax:** (480) 674-1295

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/15/2022
- **Last updated:** 04/17/2024