Provider Demographics
NPI:1235960097
Name:VOSSETT CLINICAL RESEARCH
Entity type:Organization
Organization Name:VOSSETT CLINICAL RESEARCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHNSON
Authorized Official - Middle Name:
Authorized Official - Last Name:KORIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-849-4377
Mailing Address - Street 1:10824 E TESLA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-8671
Mailing Address - Country:US
Mailing Address - Phone:832-267-8165
Mailing Address - Fax:
Practice Address - Street 1:501 W RAY RD STE 4
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-7284
Practice Address - Country:US
Practice Address - Phone:602-849-4377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center