Provider Demographics
NPI:1396420758
Name:ATLAS MEDICAL SYSTEMS, PLLC
Entity type:Organization
Organization Name:ATLAS MEDICAL SYSTEMS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ATLAS MEDICAL
Authorized Official - Prefix:
Authorized Official - First Name:ATLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDICAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-588-3165
Mailing Address - Street 1:PO BOX 32990
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-2990
Mailing Address - Country:US
Mailing Address - Phone:480-588-3165
Mailing Address - Fax:
Practice Address - Street 1:3320 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4304
Practice Address - Country:US
Practice Address - Phone:480-588-3165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty