Provider Demographics
NPI:1912188384
Name:MAXWELL GROUP
Entity Type:Organization
Organization Name:MAXWELL GROUP
Other - Org Name:THE MAXWELL GROUP LLP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOSHUA
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:623-933-8289
Mailing Address - Street 1:14678 N DEL WEBB BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-2137
Mailing Address - Country:US
Mailing Address - Phone:623-933-8289
Mailing Address - Fax:623-933-2596
Practice Address - Street 1:14678 N DEL WEBB BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2137
Practice Address - Country:US
Practice Address - Phone:623-933-8289
Practice Address - Fax:623-933-2596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZCG8234OtherRAILROAD MEDICARE
AZZWCJBJMedicare PIN