# IMD PHYSICIANS ARIZONA PLLC

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

## Provider details

- **NPI number:** 1629616727
- **Authorized official:** DR. MICAH D HALE DO (CEO)
- **Authorized official phone:** (831) 818-9833

## Contact information

- **Practice address:** 7250 N 16TH ST STE 104, PHOENIX, AZ 85020-5214
- **Practice address phone:** (602) 714-2815
- **Mailing address:** 4325 E GLACIER PLACE, PHOENIX, AZ 85029-5653
- **Mailing address phone:** (602) 318-7878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/19/2019
- **Last updated:** 03/24/2020