| 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 |