Provider Demographics
NPI:1497189138
Name:DOCTOR IS IN LLC
Entity Type:Organization
Organization Name:DOCTOR IS IN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-370-4309
Mailing Address - Street 1:450 N DOBSON RD
Mailing Address - Street 2:STE 205
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-5278
Mailing Address - Country:US
Mailing Address - Phone:480-383-8599
Mailing Address - Fax:480-398-1620
Practice Address - Street 1:8275 S EASTERN AVE
Practice Address - Street 2:STE 113
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2591
Practice Address - Country:US
Practice Address - Phone:702-370-4309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty