| Desert Fountain Medical Inc | |
|
17100 E Shea Blvd Ste 320 Fountain Hills AZ 85268-6654 | |
| (480) 816-8300 | |
| (480) 816-4016 |
| Full Name | Desert Fountain Medical Inc |
|---|---|
| Speciality | General Practice |
| Location | 17100 E Shea Blvd Ste 320, Fountain Hills, Arizona |
| Authorized Official Name and Position | Grant Andres (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4808168300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Fountain Medical Inc 17100 E Shea Blvd Ste 320 Fountain Hills AZ 85268-6654 Ph: (480) 816-8300 | Desert Fountain Medical Inc 17100 E Shea Blvd Ste 320 Fountain Hills AZ 85268-6654 Ph: (480) 816-8300 |
| NPI Number | 1558863886 |
|---|---|
| Provider Enumeration Date | 03/02/2018 |
| Last Update Date | 03/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558863886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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