Organization
TAG MEDICAL & STAFFING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW CLARK PHYSICIAN ASSISTANT (CEO)
(254) 931-8298
Entity
Organization
Contact information
Practice address
2601 N 3RD ST STE 106, PHOENIX, AZ 85004-1144
(254) 931-8298
(602) 248-8006
Mailing address
2371 E AZALEA DR, CHANDLER, AZ 85286-2365
(254) 931-8298
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1035995
NCCPA
—
01
—
2124
STATE LICENSE
AZ
Enumeration date
05/11/2019
Last updated
05/11/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up