# LANDMARK MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LANDMARK MEDICAL LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962910281
- **Legal business name:** LANDMARK MEDICAL LLC
- **Authorized official:** DR. JUSTIN D THOMPSON (MANAGER)
- **Authorized official phone:** (435) 760-5896

## Contact information

- **Practice address:** 3001 E CAMELBACK RD STE 155, PHOENIX, AZ 85016-0001
- **Practice address phone:** (602) 234-2611
- **Mailing address:** 2340 W PARKSIDE LN STE H107, PHOENIX, AZ 85027-1274
- **Mailing address phone:** (602) 354-5310
- **Mailing address fax:** (480) 887-8041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 8503 | AZ | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | 46628 | AZ | Yes |
| 208VP0000X | Pain Medicine Physician | 46628 | AZ | — |
| 225100000X | Physical Therapist | 12547 | AZ | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 363A00000X | Physician Assistant | 5090 | AZ | — |
| 363L00000X | Nurse Practitioner | AP5002 | NULL | — |
| 363L00000X | Nurse Practitioner | AP5002 | — | — |

## Other

- **Enumeration date:** 01/22/2018
- **Last updated:** 10/08/2020