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Organization
PASSPORT HEALTH HOLDINGS, LLC
Active
Organization
PASSPORT HEALTH HOLDINGS, LLC
Active
Other names
Passport Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUG SHACKELL (DIRECTOR OF FINANCE)
(480) 646-9024
Entity
Organization
Contact information
Practice address
118 HUXLEY RD STE 1, KNOXVILLE, TN 37922-3183
(877) 358-8648
(877) 877-8675
Mailing address
8324 E HARTFORD DR, #200, SCOTTSDALE, AZ 85255
(888) 909-6551
(480) 383-6567
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
TN
Other
Enumeration date
03/13/2014
Last updated
08/29/2018
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