Provider Demographics
NPI:1114481876
Name:COMPASS MEDICAL CENTER SAFFORD PLLC
Entity Type:Organization
Organization Name:COMPASS MEDICAL CENTER SAFFORD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODSIDE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-536-5525
Mailing Address - Street 1:1765 S 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAFFORD
Mailing Address - State:AZ
Mailing Address - Zip Code:85546-4012
Mailing Address - Country:US
Mailing Address - Phone:928-536-5525
Mailing Address - Fax:
Practice Address - Street 1:1765 S 20TH AVE
Practice Address - Street 2:
Practice Address - City:SAFFORD
Practice Address - State:AZ
Practice Address - Zip Code:85546-4012
Practice Address - Country:US
Practice Address - Phone:928-536-5525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty