Organization
CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC
Active
Organization
CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA AMICK (AO)
(727) 798-8160
Entity
Organization
Contact information
Practice address
7725 N 43RD AVE STE 522, PHOENIX, AZ 85051-5771
(480) 729-8341
Mailing address
15 CENTURY BLVD STE 307, NASHVILLE, TN 37214-3692
(615) 425-0220
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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