| NPI | 1184676280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA WHEELER Office Manager 928-556-0060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207R00000X Internal Medicine | |
| 207RC0200X Internal Medicine, Critical Care Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-08-22 |