Provider Demographics
NPI:1225770456
Name:ALPHAMED CHANDLER LLC
Entity Type:Organization
Organization Name:ALPHAMED CHANDLER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:OVERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:602-689-9588
Mailing Address - Street 1:4949 S ARIZONA AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-4619
Mailing Address - Country:US
Mailing Address - Phone:480-847-2225
Mailing Address - Fax:
Practice Address - Street 1:4949 S ARIZONA AVE STE 4
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-4619
Practice Address - Country:US
Practice Address - Phone:480-847-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MADISON MEDICAL PARTNERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty