Organization
MEDEXAZ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK J MITREY (MANAGING DIRECTOR)
(602) 284-8265
Entity
Organization
Contact information
Practice address
32 SPUR CIR, SCOTTSDALE, AZ 85251-5461
(602) 284-8265
Mailing address
32 SPUR CIR, SCOTTSDALE, AZ 85251-5461
(602) 284-8265
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1023087293
AZ
208D00000X
General Practice Physician
Primary
1023087293
AZ
363LF0000X
Family Nurse Practitioner
1023087293
AZ
Other
Enumeration date
12/01/2014
Last updated
12/15/2014
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