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Organization

REVOLUTION MEDICAL CENTER, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JESSE SAGE HAGGARD N.M.D. (CLINIC DIRECTOR)
(602) 463-7177
Entity
Organization

Contact information

Practice address
2015 E CAMELBACK RD, PHOENIX, AZ 85016-4710
(602) 840-4400
(602) 840-0490
Mailing address
2015 E CAMELBACK RD, PHOENIX, AZ 85016-4710
(602) 840-4400
(602) 840-0490

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
04836
AZ

Other

Enumeration date
11/28/2007
Last updated
11/28/2007
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