Ellsworth Medical Group Llc | |
21323 S Ellsworth Loop Rd Ste 101, Queen Creek, AZ 85142-9865 | |
(480) 307-8440 | |
Not Available |
Full Name | Ellsworth Medical Group Llc |
---|---|
Type | Facility |
Speciality | General Practice |
Location | 21323 S Ellsworth Loop Rd Ste 101, Queen Creek, Arizona |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467928804 | NPI | - | NPPES |
Provider Name | John J Koc |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1659429215 PECOS PAC ID: 1951200609 Enrollment ID: I20040102000119 |
Provider Name | Sonja Gerard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366719965 PECOS PAC ID: 0941460018 Enrollment ID: I20120327000757 |
Provider Name | Orlando Hubbell |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1225410467 PECOS PAC ID: 5799089785 Enrollment ID: I20160211002426 |
Provider Name | Lisa Lombard |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1083784987 PECOS PAC ID: 1355376781 Enrollment ID: I20160309001615 |
Provider Name | Collin S Cragun |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1770003816 PECOS PAC ID: 8426328741 Enrollment ID: I20170927002321 |
Provider Name | Genesis Larkins |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1194426080 PECOS PAC ID: 3072988559 Enrollment ID: I20230414001567 |
Provider Name | Amberlyn June Plath |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891439592 PECOS PAC ID: 1658819339 Enrollment ID: I20240813001151 |
Provider Name | Douglas Beaudette |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1437249521 PECOS PAC ID: 6002891140 Enrollment ID: I20241120001119 |
Mailing Address | Practice Location Address |
---|---|
Ellsworth Medical Group Llc Po Box 6610, Chandler, AZ 85246-6610 Ph: (480) 926-7800 | Ellsworth Medical Group Llc 21323 S Ellsworth Loop Rd Ste 101, Queen Creek, AZ 85142-9865 Ph: (480) 307-8440 |