Organization
AZURE HEALTH AT GILBERT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS CLOUSE MD (MEMBER MANAGER)
(480) 899-4333
Entity
Organization
Contact information
Practice address
3530 S VAL VISTA DR STE B105, GILBERT, AZ 85297-7318
(480) 899-4333
Mailing address
PO BOX 64568, PHOENIX, AZ 85082-4568
(480) 374-7200
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
111N00000X
Chiropractor
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
01/18/2019
Last updated
01/18/2019
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