Provider Demographics
NPI:1538202486
Name:MESA OBSTETRICIANS AND GYNECOLOGISTS, LTD
Entity type:Organization
Organization Name:MESA OBSTETRICIANS AND GYNECOLOGISTS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHENK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-469-5889
Mailing Address - Street 1:PO BOX 1377
Mailing Address - Street 2:
Mailing Address - City:HIGLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85236-1377
Mailing Address - Country:US
Mailing Address - Phone:602-816-5544
Mailing Address - Fax:602-626-8681
Practice Address - Street 1:801 S POWER RD STE 108
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-5222
Practice Address - Country:US
Practice Address - Phone:602-816-5544
Practice Address - Fax:602-626-8681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZF00471OtherPHX HEALTH PLAN
AZZWCHVZOtherPTAN