Basic Information
| Provider Information | |||||||||
| NPI: | 1578717682 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | APOGEE MEDICAL GROUP TENNESSEE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2049 | ||||||||
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| City: | SANDY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840912049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668692395 | ||||||||
| FaxNumber: | 8013529502 | ||||||||
| Practice Location | |||||||||
| Address1: | 15059 N SCOTTSDALE ROAD | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852542685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6027783600 | ||||||||
| FaxNumber: | 6027783695 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2008 | ||||||||
| LastUpdateDate: | 08/11/2020 | ||||||||
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| AuthorizedOfficialLastName: | HARWELL | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
| AuthorizedOfficialMiddleName: | J. | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 6027783600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist | 363A00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 208D00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.