Provider Demographics
NPI:1710286539
Name:INSIGHT ENERGY MEDICINE
Entity Type:Organization
Organization Name:INSIGHT ENERGY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIFLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-654-0474
Mailing Address - Street 1:7254 E SOUTHERN AVE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-2786
Mailing Address - Country:US
Mailing Address - Phone:480-654-0474
Mailing Address - Fax:480-807-3879
Practice Address - Street 1:7254 E SOUTHERN AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-2786
Practice Address - Country:US
Practice Address - Phone:480-654-0474
Practice Address - Fax:480-807-3879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ111N00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty