| East Scottsdale Medical Care, Pllc | |
|
10565 N 114th St # 103 Scottsdale AZ 85259-4942 | |
| (480) 621-3505 | |
| Not Available |
| Full Name | East Scottsdale Medical Care, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 10565 N 114th St # 103, Scottsdale, Arizona |
| Authorized Official Name and Position | Jeffrey James Baird (OWNER) |
| Authorized Official Contact | 4806213505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Scottsdale Medical Care, Pllc 10565 N 114th St # 103 Scottsdale AZ 85259-4942 Ph: (480) 621-3505 | East Scottsdale Medical Care, Pllc 10565 N 114th St # 103 Scottsdale AZ 85259-4942 Ph: (480) 621-3505 |
| NPI Number | 1154452076 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4385742782 |
|---|---|
| Medicare Enrollment ID | O20070608000195 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154452076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 19007 (Arizona) | Primary |
| Provider Name | Julie A Longmire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710384193 PECOS PAC ID: 5698080109 Enrollment ID: I20150812008961 |
| Provider Name | Tracie Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720608961 PECOS PAC ID: 0547691891 Enrollment ID: I20200520003151 |
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