# DISTRICT MEDICAL GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DISTRICT MEDICAL GROUP, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1629301734
- **Legal business name:** DISTRICT MEDICAL GROUP, INC
- **Authorized official:** TERESA CORDEIRO (CREDENTIALING DIRECTOR)
- **Authorized official phone:** (602) 470-5000

## Contact information

- **Practice address:** 2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
- **Practice address phone:** (602) 470-5000
- **Mailing address:** 2929 E THOMAS RD, PHOENIX, AZ 85016-8034
- **Mailing address phone:** (602) 470-5000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | — | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | NULL | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 09/09/2009
- **Last updated:** 10/01/2014