Provider Demographics
NPI:1861722233
Name:SAXON MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:SAXON MEDICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-307-6790
Mailing Address - Street 1:10645 N TATUM BLVD
Mailing Address - Street 2:SUITE 200-629
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3068
Mailing Address - Country:US
Mailing Address - Phone:480-307-6790
Mailing Address - Fax:
Practice Address - Street 1:10645 N TATUM BLVD
Practice Address - Street 2:SUITE 200-629
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3068
Practice Address - Country:US
Practice Address - Phone:480-307-6790
Practice Address - Fax:480-307-6938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-07
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty