# MEDICALLY DIRECTED CARE CLINIC PHOENIX, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548037732
- **Authorized official:** MR. JEFFREY LORAN WEBB (OWNER)
- **Authorized official phone:** (602) 326-5932

## Contact information

- **Practice address:** 1425 S HIGLEY RD, GILBERT, AZ 85296-4798
- **Practice address phone:** (480) 870-1414
- **Mailing address:** 3714 S PONDEROSA DR, GILBERT, AZ 85297-7422
- **Mailing address phone:** (602) 326-5932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 12/07/2023
- **Last updated:** 12/07/2023