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Organization

ARCHWELL HEALTH PROFESSIONAL SERVICES OF ARIZONA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMY MODDESETTE (SR. DIRECTOR, MANAGED CARE OPS)
(629) 224-1614
Entity
Organization

Contact information

Practice address
4315 E MAIN ST, MESA, AZ 85205-8605
(480) 870-7500
(480) 906-2173
Mailing address
102 WOODMONT BLVD STE 600, NASHVILLE, TN 37205-5250

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
207R00000X
Internal Medicine Physician
Primary
207RG0300X
Geriatric Medicine (Internal Medicine) Physician

Other

Enumeration date
11/02/2021
Last updated
03/11/2026
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