NPI | 1922720333 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN ERNEST WILLIAMS Executive Director 928-459-3400 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
363LA2200X Nurse Practitioner, Adult Health | |
363LG0600X Nurse Practitioner, Gerontology | |
Enumeration Date | 2022-09-13 |
Last Update Date | 2022-09-13 |