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Organization
ATLANTIS MEDICAL GROUP AZ PLLC
Active
Organization
ATLANTIS MEDICAL GROUP AZ PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PRESTON HARPER (CREDENTIALING SPECIALIST)
(505) 553-8466
Entity
Organization
Contact information
Practice address
11047 N 19TH AVE, PHOENIX, AZ 85029-4816
(602) 589-0500
(602) 314-4552
Mailing address
11047 N 19TH AVE, PHOENIX, AZ 85029-4816
(602) 802-8636
(602) 314-4552
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
—
NULL
207LA0401X
Addiction Medicine (Anesthesiology) Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
NULL
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
11/22/2013
Last updated
08/25/2026
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