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Organization

ARIZONA SPORTS MEDICINE CENTER PLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JASON R MOORE MBA (EXECUTIVE DIRECTOR)
(480) 889-1580
Entity
Organization

Contact information

Practice address
8630 E VIA DE VENTURA, SUITE 201, SCOTTSDALE, AZ 85258-3326
(480) 558-3744
(480) 558-3801
Mailing address
8630 E VIA DE VENTURA, SUITE 201, SCOTTSDALE, AZ 85258-3326
(480) 558-3744
(480) 558-3801

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
AZ

Other

Enumeration date
08/18/2014
Last updated
08/18/2014
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