Provider Demographics
NPI:1013206366
Name:VISITSATHOMEMD LLC
Entity Type:Organization
Organization Name:VISITSATHOMEMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:N
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-388-3676
Mailing Address - Street 1:8160 E BUTHERUS DR
Mailing Address - Street 2:STE 7
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2671
Mailing Address - Country:US
Mailing Address - Phone:623-388-3676
Mailing Address - Fax:
Practice Address - Street 1:8160 E BUTHERUS DR
Practice Address - Street 2:STE 7
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2671
Practice Address - Country:US
Practice Address - Phone:623-388-3676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty