Business Office | |
1205 F. Avenue Douglas AZ 85607 | |
(520) 364-1429 | |
(520) 364-4261 |
Full Name | Business Office |
---|---|
Speciality | Clinic/Center |
Location | 1205 F. Avenue, Douglas, Arizona |
Authorized Official Name and Position | Jonathan Melk (CEO) |
Authorized Official Contact | 5203641429 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Business Office 1205 F Ave Douglas AZ 85607-1920 Ph: (520) 364-1429 | Business Office 1205 F. Avenue Douglas AZ 85607 Ph: (520) 364-1429 |
NPI Number | 1942241443 |
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Provider Enumeration Date | 06/08/2006 |
Last Update Date | 02/08/2017 |
Medicare PECOS PAC ID | 5395638878 |
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Medicare Enrollment ID | O20040206000860 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942241443 | NPI | - | NPPES |
433053 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Kathleen J Vedock |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1235103508 PECOS PAC ID: 4082506001 Enrollment ID: I20040325001276 |
Provider Name | Rita G Kilgore |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1861472516 PECOS PAC ID: 3375537525 Enrollment ID: I20040412001054 |
Provider Name | Carter C Mayberry |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295777308 PECOS PAC ID: 9638064231 Enrollment ID: I20050510000654 |
Provider Name | Darlene R Melk |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1578523338 PECOS PAC ID: 4587693957 Enrollment ID: I20050805000397 |
Provider Name | Andrew W Mayberry |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629019260 PECOS PAC ID: 4385657014 Enrollment ID: I20060726000029 |
Provider Name | Jonathan P Melk |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1568496164 PECOS PAC ID: 4385647775 Enrollment ID: I20060920000052 |
Provider Name | Lucy Burciaga |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1497835649 PECOS PAC ID: 4486636891 Enrollment ID: I20070228000142 |
Provider Name | Karen E Crockett |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316009079 PECOS PAC ID: 8123110558 Enrollment ID: I20070815000475 |
Provider Name | Peter A Rice |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1083639256 PECOS PAC ID: 9931291564 Enrollment ID: I20070827000738 |
Provider Name | Shirley L Bayham-hicks |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144216920 PECOS PAC ID: 8224102173 Enrollment ID: I20080811000539 |
Provider Name | Jane A Williamson-davenport |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689823874 PECOS PAC ID: 4981763349 Enrollment ID: I20081030000549 |
Provider Name | Lisa A Bilek |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407981368 PECOS PAC ID: 1355482183 Enrollment ID: I20091230000561 |
Provider Name | Dia C Madden |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215241518 PECOS PAC ID: 2668667122 Enrollment ID: I20101109001574 |
Provider Name | Milla S Rosen |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1144289760 PECOS PAC ID: 8820285885 Enrollment ID: I20101203000418 |
Provider Name | Elizabeth M Fabry |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780685370 PECOS PAC ID: 3779766381 Enrollment ID: I20110318000830 |
Provider Name | Mary K Mcneff |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982869475 PECOS PAC ID: 7012084262 Enrollment ID: I20110531000249 |
Provider Name | Melba J Travis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700156510 PECOS PAC ID: 0648434092 Enrollment ID: I20120614000372 |
Provider Name | Tammy L Posey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760784342 PECOS PAC ID: 2567613482 Enrollment ID: I20121127000068 |
Provider Name | Douglas A Simmons |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780813832 PECOS PAC ID: 8123269594 Enrollment ID: I20130726000679 |
Provider Name | Amy Christine Clark |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1649595174 PECOS PAC ID: 2062666449 Enrollment ID: I20140908001013 |
Provider Name | Jennifer Rebecca Albon |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1497054639 PECOS PAC ID: 8123279908 Enrollment ID: I20141031001038 |
Provider Name | Kimberly E Riggs |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760886220 PECOS PAC ID: 5597082354 Enrollment ID: I20150317000045 |
Provider Name | Steven Kenneth Dahlke |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1710976337 PECOS PAC ID: 5496908295 Enrollment ID: I20150515001286 |
Provider Name | Tamika M Sullivan |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1770814790 PECOS PAC ID: 0143444851 Enrollment ID: I20150724010804 |
Provider Name | Nori Ruo |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1710922018 PECOS PAC ID: 7113232604 Enrollment ID: I20150812008395 |
Provider Name | Devyn Rene Thurber |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255707352 PECOS PAC ID: 1951619816 Enrollment ID: I20150928000368 |
Provider Name | Valerie Matthew |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1770894842 PECOS PAC ID: 6709018401 Enrollment ID: I20151009001160 |
Provider Name | Zachary S Patterson |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1326335852 PECOS PAC ID: 6002125648 Enrollment ID: I20151021001351 |
Provider Name | Ana Ingeborg Tejero |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1043422629 PECOS PAC ID: 0749325934 Enrollment ID: I20151021002398 |
Provider Name | Hadi Safavi |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508124686 PECOS PAC ID: 4284943739 Enrollment ID: I20151022002401 |
Provider Name | Roberto C. Pardo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922482108 PECOS PAC ID: 2860796208 Enrollment ID: I20160205000777 |
Provider Name | Kerstin P Hurley |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1710342043 PECOS PAC ID: 7911203062 Enrollment ID: I20160315002874 |
Provider Name | Leonard Atencio |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346622271 PECOS PAC ID: 0547564221 Enrollment ID: I20160404001266 |
Provider Name | Karina C Bechtold |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598129454 PECOS PAC ID: 5597064204 Enrollment ID: I20160502001731 |
Provider Name | Tonya L Johnson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679825152 PECOS PAC ID: 7214152206 Enrollment ID: I20160725001700 |
Provider Name | Ivan R Rodriguez Kalaf |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1205260221 PECOS PAC ID: 1850688821 Enrollment ID: I20160920001520 |
Provider Name | Lakeisha S Love |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205381472 PECOS PAC ID: 1850688292 Enrollment ID: I20160928001414 |
Provider Name | Eduardo A Marrero Velis |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1144560160 PECOS PAC ID: 3476841818 Enrollment ID: I20161018000627 |
Provider Name | Claudia Patricia Pleitez Tecun |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1710388954 PECOS PAC ID: 1557665106 Enrollment ID: I20161018002585 |
Provider Name | Pamela Catherine Oliphant |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1174072326 PECOS PAC ID: 1658650882 Enrollment ID: I20161110002565 |
Provider Name | Lisa E Johnson |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1356617211 PECOS PAC ID: 1951623313 Enrollment ID: I20161216000967 |
Provider Name | Jamie L Kearney |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619413895 PECOS PAC ID: 1052696994 Enrollment ID: I20170322001575 |
Provider Name | Heidi A Mcguigan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770556730 PECOS PAC ID: 1951341205 Enrollment ID: I20170531001392 |
Provider Name | Rebecca A Lamas |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467972133 PECOS PAC ID: 1951671247 Enrollment ID: I20170719002113 |
Provider Name | Sarah R Earnest |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1942684394 PECOS PAC ID: 5496025512 Enrollment ID: I20170724001134 |
Provider Name | Tandie T Myles |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1528418423 PECOS PAC ID: 8820360555 Enrollment ID: I20170815004623 |
Provider Name | Jeffrey Richard Holzberg |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1235556168 PECOS PAC ID: 7416279237 Enrollment ID: I20170914002407 |
Provider Name | Jennifer H Smith |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1366601932 PECOS PAC ID: 5991830499 Enrollment ID: I20180221001791 |
Provider Name | Chelsey M Housley |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1467954594 PECOS PAC ID: 3870855190 Enrollment ID: I20180327001399 |
Provider Name | Christine R Grassman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689111817 PECOS PAC ID: 1052676939 Enrollment ID: I20180523002741 |
Provider Name | Daniel A Driscoll |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1689744591 PECOS PAC ID: 2365480019 Enrollment ID: I20180730000258 |
Provider Name | Jennifer Schafer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245726447 PECOS PAC ID: 4587912670 Enrollment ID: I20180806003163 |
Provider Name | Katrina L Ventura-morano |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1396127742 PECOS PAC ID: 3678823069 Enrollment ID: I20180905003451 |
Provider Name | Nicole L Williams |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1013498328 PECOS PAC ID: 7618940735 Enrollment ID: I20181024003393 |
Provider Name | Kayla Rose Percy |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134698160 PECOS PAC ID: 5092055707 Enrollment ID: I20190320000122 |
Provider Name | Megan S Matz |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1184071524 PECOS PAC ID: 6103159587 Enrollment ID: I20190618001618 |
Provider Name | Kelly Edmonds Barrington |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033777560 PECOS PAC ID: 7810225182 Enrollment ID: I20190823002131 |
Provider Name | Elaine Y Shan |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1053767434 PECOS PAC ID: 6305101437 Enrollment ID: I20190910000048 |
Provider Name | Gustavo Durazo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427600782 PECOS PAC ID: 4385078799 Enrollment ID: I20191217003291 |
Provider Name | Paula B Bird |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1144593997 PECOS PAC ID: 5193150167 Enrollment ID: I20200121002561 |
Provider Name | Rebekah E Charry |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821650201 PECOS PAC ID: 8527492271 Enrollment ID: I20200204002274 |
Provider Name | Marlyne L Perez |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1386002335 PECOS PAC ID: 5193152742 Enrollment ID: I20200304000752 |
Provider Name | Neftali F Fernandez |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1215015821 PECOS PAC ID: 1951448745 Enrollment ID: I20200311001067 |
Provider Name | Jessica Lea Watters |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427231729 PECOS PAC ID: 5294991295 Enrollment ID: I20200519001035 |
Provider Name | Kara Joy Merrell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811527708 PECOS PAC ID: 4082037809 Enrollment ID: I20200710002993 |
Provider Name | Mary Emilia Fairbanks |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457360406 PECOS PAC ID: 6507817350 Enrollment ID: I20200817000653 |
Provider Name | Courtney Schinner |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1972110948 PECOS PAC ID: 8325467533 Enrollment ID: I20201007000801 |
Provider Name | Joshua Jean |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1891236220 PECOS PAC ID: 0042567836 Enrollment ID: I20201016001865 |
Provider Name | Jessica R Napier |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720674187 PECOS PAC ID: 8820402845 Enrollment ID: I20210202001586 |
Provider Name | Natalie R Krumdieck |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467815100 PECOS PAC ID: 7719272467 Enrollment ID: I20210225002507 |
Provider Name | Tawnya R Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477836971 PECOS PAC ID: 4486933199 Enrollment ID: I20210326001986 |
Provider Name | Bart M Diaz |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1366556706 PECOS PAC ID: 8325449689 Enrollment ID: I20210624002308 |
Provider Name | Jonathan Adin Sinnott |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225467723 PECOS PAC ID: 2567867310 Enrollment ID: I20210817004191 |
Provider Name | Yulemi Velazco |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1649761578 PECOS PAC ID: 3678824059 Enrollment ID: I20210915001592 |
Provider Name | Bagambhrini Thompkins |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851885628 PECOS PAC ID: 6406254523 Enrollment ID: I20211004003050 |
Provider Name | Glenn David Tanita |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1669632006 PECOS PAC ID: 6002705977 Enrollment ID: I20211124001606 |
Provider Name | Heather L Kinder |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295240885 PECOS PAC ID: 3870983349 Enrollment ID: I20211124001746 |
Provider Name | Kirsten Nicole Mellott |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1891368452 PECOS PAC ID: 7012312978 Enrollment ID: I20211208002953 |
Provider Name | Connie S Herrera |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1932691060 PECOS PAC ID: 6608128251 Enrollment ID: I20211216000748 |
Provider Name | Ariel Sharon Palter |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538630900 PECOS PAC ID: 7618202060 Enrollment ID: I20211216001599 |
Provider Name | Nicole Marie Baldenegro |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679081871 PECOS PAC ID: 5799178992 Enrollment ID: I20220211000506 |
Provider Name | Jonathan Howell Rutherford |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154091932 PECOS PAC ID: 1456744341 Enrollment ID: I20220217002193 |
Provider Name | Brittany Nichole Boegemann |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659043552 PECOS PAC ID: 3779970058 Enrollment ID: I20220505001167 |
Provider Name | Victoria L Ochoa |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841946183 PECOS PAC ID: 0042607541 Enrollment ID: I20220520001274 |
Provider Name | Gino Jose Bardi Lola |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1700230109 PECOS PAC ID: 3971830464 Enrollment ID: I20220615001320 |
Provider Name | Chine Quetzalcoatl Tan Myers |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295453165 PECOS PAC ID: 5698151967 Enrollment ID: I20221011000347 |
Provider Name | Samantha K Bassett |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285360230 PECOS PAC ID: 8729455712 Enrollment ID: I20221103002467 |
Provider Name | Dawn Azbill |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285372474 PECOS PAC ID: 2466824222 Enrollment ID: I20230206000609 |
Provider Name | Anahi Huang Hsu |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740742931 PECOS PAC ID: 0143692681 Enrollment ID: I20230210000380 |
Provider Name | Gouni Lakoso Bouraima |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427623990 PECOS PAC ID: 1153798210 Enrollment ID: I20230222002466 |
Provider Name | Deanna Lee Merrill |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396345955 PECOS PAC ID: 3971976176 Enrollment ID: I20230309001665 |
Provider Name | Christine Anne O'toole |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1003465600 PECOS PAC ID: 6002289170 Enrollment ID: I20230310002074 |
Provider Name | Lilia Lara |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073231742 PECOS PAC ID: 7517331036 Enrollment ID: I20230324000948 |
Provider Name | Hannah Isabel Ruben |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134895907 PECOS PAC ID: 1759756919 Enrollment ID: I20230331002125 |
Provider Name | Clarel Neuvieme |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114644432 PECOS PAC ID: 0143692608 Enrollment ID: I20230405000780 |
Provider Name | Gabrielle Alexandra Lugo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174075964 PECOS PAC ID: 6709241888 Enrollment ID: I20230424002943 |
Provider Name | Rebecca Satter |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467097295 PECOS PAC ID: 0648643643 Enrollment ID: I20230515002856 |
Provider Name | Jamie Lynn Fitzpatrick |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467145904 PECOS PAC ID: 8123487758 Enrollment ID: I20230629002973 |
Provider Name | Catherine Khanh-an Vu |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1437779238 PECOS PAC ID: 6305290644 Enrollment ID: I20230920003349 |
Provider Name | Gavelyn Poonnopatam |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962021378 PECOS PAC ID: 0547614984 Enrollment ID: I20231003003602 |
Provider Name | Patrick Donald Thurber |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265114037 PECOS PAC ID: 7113372855 Enrollment ID: I20231016001792 |
Provider Name | Sandra G Matheny |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134854615 PECOS PAC ID: 1153777289 Enrollment ID: I20231026000956 |
Provider Name | Jana Walker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174201511 PECOS PAC ID: 7416305990 Enrollment ID: I20231121003175 |
Provider Name | Cassandra Rose Steiner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780328617 PECOS PAC ID: 0345699732 Enrollment ID: I20231211002010 |
Provider Name | Jane Louise Lorenz |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1316298417 PECOS PAC ID: 9638520430 Enrollment ID: I20240105001636 |
Provider Name | Jaimie Callison |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1164129466 PECOS PAC ID: 2163873985 Enrollment ID: I20240105002458 |
Provider Name | Laura Acero |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1417094012 PECOS PAC ID: 0648425249 Enrollment ID: I20240221000992 |
Provider Name | Sherri Arenas |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1386187680 PECOS PAC ID: 1052757440 Enrollment ID: I20240307002295 |
Provider Name | Ana Rebecca Toothman |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1831488642 PECOS PAC ID: 1456798354 Enrollment ID: I20240327003593 |
Red Canyon Infectious Disease Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2174 W Oak Ave, Douglas, AZ 85607 Phone: 520-366-0335 Fax: 520-366-0388 | |
Chiricahua Community Health Centers Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1111 N F Ave, Douglas, AZ 85607 Phone: 520-364-1429 | |
Chiricahua Community Health Centers, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 815 15th Street, Douglas, AZ 85607 Phone: 520-364-5437 Fax: 520-364-4261 | |
Douglas Family Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1101 N San Antonio Ave, Douglas, AZ 85607 Phone: 520-417-3001 Fax: 520-417-3297 | |
Community Healthcare Of Douglas Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2174 W Oak Ave, Douglas, AZ 85607 Phone: 520-364-7931 Fax: 520-364-2551 | |
Douglas Family Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1906 E 11th St, Douglas, AZ 85607 Phone: 520-364-1120 Fax: 520-364-6417 | |
Ginger Ryan Clinic-dsmes Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1100 N F Ave, Douglas, AZ 85607 Phone: 520-364-3285 |