| NPI | 1588168504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI C ENGLE Director Of Staffing & Credentialin 928-247-6516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 35023) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy |
| 207RC0000X Internal Medicine Cardiovascular Disease | |
| 207RR0500X Internal Medicine Rheumatology | |
| 207UN0901X Nuclear Medicine Nuclear Cardiology | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 2085U0001X Radiology Diagnostic Ultrasound | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2023-08-04 |