Provider Demographics
NPI:1598558694
Name:JAMES DAVID MILACEK PLLC
Entity type:Organization
Organization Name:JAMES DAVID MILACEK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MILACEK
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, PMHNP-BC
Authorized Official - Phone:623-229-2175
Mailing Address - Street 1:10000 N 31ST AVE STE C302
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-9569
Mailing Address - Country:US
Mailing Address - Phone:602-843-0000
Mailing Address - Fax:833-377-0510
Practice Address - Street 1:10000 N 31ST AVE STE C302
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-9569
Practice Address - Country:US
Practice Address - Phone:602-843-0000
Practice Address - Fax:833-377-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty