Provider Demographics
NPI:1841984564
Name:DESERT FOOTHILLS CONCIERGE MEDICINE, LLC
Entity type:Organization
Organization Name:DESERT FOOTHILLS CONCIERGE MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:UHRIG
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:480-980-2735
Mailing Address - Street 1:28150 N ALMA SCHOOL PKWY STE 103-493
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-8133
Mailing Address - Country:US
Mailing Address - Phone:480-980-2735
Mailing Address - Fax:
Practice Address - Street 1:27805 N 154TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85262-7729
Practice Address - Country:US
Practice Address - Phone:480-694-8540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty