Provider Demographics
NPI:1760696025
Name:ARIZONA SPORTS MEDICINE CONSULTANTS PC
Entity Type:Organization
Organization Name:ARIZONA SPORTS MEDICINE CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD MS
Authorized Official - Phone:602-493-1626
Mailing Address - Street 1:4530 N 32ND ST
Mailing Address - Street 2:# 102
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018
Mailing Address - Country:US
Mailing Address - Phone:602-493-1626
Mailing Address - Fax:602-218-6872
Practice Address - Street 1:4530 N 32ND ST
Practice Address - Street 2:# 102
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018
Practice Address - Country:US
Practice Address - Phone:602-493-1626
Practice Address - Fax:602-218-6872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ247202080S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports MedicineGroup - Multi-Specialty