Provider Demographics
NPI:1629424379
Name:MOBILEONEDOCS, LLC
Entity Type:Organization
Organization Name:MOBILEONEDOCS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEN
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SWANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-843-9877
Mailing Address - Street 1:10115 E BELL RD
Mailing Address - Street 2:#107-234
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2189
Mailing Address - Country:US
Mailing Address - Phone:888-709-8721
Mailing Address - Fax:888-709-8721
Practice Address - Street 1:10115 E BELL RD
Practice Address - Street 2:#107-234
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2189
Practice Address - Country:US
Practice Address - Phone:888-709-8721
Practice Address - Fax:888-709-8721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ190006OtherMEDICARE
AZ372018Medicaid
NV250003311Medicaid
AZZ190006OtherMEDICARE