| NPI | 1073699112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AZAM S. KHAN Chief Administrative Officer 928-757-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 213E00000X Podiatrist | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 208600000X Surgery | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2018-06-04 |