Provider Demographics
NPI:1265972517
Name:THE MELTZER CLINIC
Entity type:Organization
Organization Name:THE MELTZER CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:
Authorized Official - Last Name:MELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-657-7006
Mailing Address - Street 1:7025 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-3675
Mailing Address - Country:US
Mailing Address - Phone:480-657-7006
Mailing Address - Fax:
Practice Address - Street 1:7025 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 302
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-3675
Practice Address - Country:US
Practice Address - Phone:480-657-7006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36876208200000X
AZRN096719363LF0000X
AZ30910208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ174565Medicare UPIN