NPI 1578004008

Passport Health Holdings, LLC

Organisation Public Health & General Preventive Medicine Physician Flagstaff, AZ

Practice location

Address: 1116 E Route 66, Flagstaff, AZ 86001-4706
Phone: (877) 358-8648
Fax: (877) 877-6875
Mailing address: 8324 E Hartford Dr STE 200, Scottsdale, AZ 85255-7801

Authorised official

Name: Doug Shackell
Title: Director of Finance
Phone: (480) 646-9024

Registered specialties

Public Health & General Preventive Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083P0901X

Other Preventive Medicine providers in Arizona →

Registry record

NPI: 1578004008
Entity type: Organization
NPI issued: 16 Mar 2017
Record last updated: 16 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.