| NPI | 1336255264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA JEAN JENKINS Office Manager 480-964-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 2584) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 2764) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2023-07-20 |