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Contact Information

INGENUITY MEDICAL GROUP LLC
1930 E THOMAS RD
PHOENIX, AZ85016-7711
 Phone: 480-296-6549
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Emergency Medical Services

207PE0004X 93 Physician/Emergency Medicine
 

Undersea and Hyperbaric Medicine

207PE0005X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for INGENUITY MEDICAL GROUP LLC

NPI Number 1417986118
LBN Legal business name INGENUITY MEDICAL GROUP LLC
Authorized official MARK SMITH - (BUSINESS MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/03/2006
Last updated 04/20/2008 - About 18 years ago
Identifiers
AZ Medicaid 763484
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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