| NPI | 1194977520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY PAYNE Office Manager 928-344-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: AZ 35717) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 19608) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: AZ 34512) | |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |