Organization
IMD PHYSICIANS ARIZONA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICAH D HALE DO (CEO)
(831) 818-9833
Entity
Organization
Contact information
Practice address
7250 N 16TH ST STE 104, PHOENIX, AZ 85020-5214
(602) 714-2815
Mailing address
4325 E GLACIER PLACE, PHOENIX, AZ 85029-5653
(602) 318-7878
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
12/19/2019
Last updated
03/24/2020
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