Tech Med Corp

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

10050 Issued in AZ

Legal business name

TECH MED CORP

Practice address

123 E Baseline Rd
Tempe, AZ 85283-1270

Phone

(602) 503-2849

NPI assigned

Jun 15, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gary Petersen

Title

Ceo

Phone

(602) 503-2849

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1487975207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 E BASELINE RD",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E BASELINE RD",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831270",
            "telephone_number": "602-503-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TECH MED CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-503-2849"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "10050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.