| |
3777 Crossings Dr Prescott AZ 86305-7121 | |
(623) 934-5600 | |
(623) 934-5603 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 3777 Crossings Dr, Prescott, Arizona |
Authorized Official Name and Position | Melissa Mayoral (ACCOUNTS MANAGER) |
Authorized Official Contact | 6028204709 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 47729 Phoenix AZ 85068-7729 Ph: (623) 934-5600 | 3777 Crossings Dr Prescott AZ 86305-7121 Ph: (623) 934-5600 |
NPI Number | 1619998705 |
---|---|
Provider Enumeration Date | 07/22/2006 |
Last Update Date | 02/07/2025 |
Medicare PECOS PAC ID | 0840100608 |
---|---|
Medicare Enrollment ID | O20040116000332 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619998705 | NPI | - | NPPES |
CK3166 | Other | AZ | RAIL ROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Ketan Jani |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1679575054 PECOS PAC ID: 5294789376 Enrollment ID: I20050912000852 |
Provider Name | Mohammad-ali A El-harakeh |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1184829061 PECOS PAC ID: 5395815799 Enrollment ID: I20080528000137 |
Provider Name | Onkar Bhowra |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1942306535 PECOS PAC ID: 8921918780 Enrollment ID: I20110615000830 |
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 | |