Provider Demographics
NPI:1780957985
Name:CLEAR CHOICE PHYSICIANS, LLC
Entity type:Organization
Organization Name:CLEAR CHOICE PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KUY
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-654-3303
Mailing Address - Street 1:PO BOX 668
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85299-0668
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6328 E BROWN RD STE 106
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-4841
Practice Address - Country:US
Practice Address - Phone:480-654-3303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ923261Medicaid