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722 N Montezuma St Prescott AZ 86301-2002 | |
(928) 237-9000 | |
(928) 237-9011 |
Full Name | |
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Speciality | Internal Medicine |
Location | 722 N Montezuma St, Prescott, Arizona |
Authorized Official Name and Position | Ajith Purush (MEMBER) |
Authorized Official Contact | 9287101533 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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722 N Montezuma St Prescott AZ 86301-2002 Ph: (928) 237-9000 | 722 N Montezuma St Prescott AZ 86301-2002 Ph: (928) 237-9000 |
NPI Number | 1487967519 |
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Provider Enumeration Date | 07/18/2010 |
Last Update Date | 11/16/2020 |
Medicare PECOS PAC ID | 0941494785 |
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Medicare Enrollment ID | O20101105000110 |
Identifier | Type | State | Issuer |
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1487967519 | NPI | - | NPPES |
P00217872 | Other | AZ | RR MEDICARE |
Provider Name | Ajith Purush |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1699761437 PECOS PAC ID: 9335192699 Enrollment ID: I20050225000794 |
Provider Name | Virginia I Greene |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760758981 PECOS PAC ID: 4587989355 Enrollment ID: I20150219001147 |
Provider Name | Tess Barnes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457705154 PECOS PAC ID: 3577824184 Enrollment ID: I20180222001235 |
Provider Name | Kristen Elizabeth Reiter |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528638418 PECOS PAC ID: 4385046341 Enrollment ID: I20210713002562 |
Ellen F Bunch Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1456 W Gurley St, Prescott, AZ 86305 Phone: 928-777-8880 Fax: 928-777-8884 | |
Fred S Markham Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 804 Ainsworth Dr, Suite 104, Prescott, AZ 86301 Phone: 928-778-1736 Fax: 928-717-0785 | |
Yavapai Regional Medical Center Physician Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 726 Gail Gardner Way, Suite B, Prescott, AZ 86305 Phone: 928-445-0304 | |