Provider Demographics
NPI:1467195347
Name:ADDICTION NAVIGATORS PLLC
Entity Type:Organization
Organization Name:ADDICTION NAVIGATORS PLLC
Other - Org Name:ADDICTION NAVIGATORS PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN, SOLE MEMBER, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:CARVEL
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-737-1955
Mailing Address - Street 1:303 N CENTENNIAL WAY
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-6733
Mailing Address - Country:US
Mailing Address - Phone:480-737-1955
Mailing Address - Fax:480-219-5347
Practice Address - Street 1:303 N CENTENNIAL WAY
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-6733
Practice Address - Country:US
Practice Address - Phone:480-737-1955
Practice Address - Fax:480-219-5347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty