| East Valley Primary Care Physicians Plc | |
|
4515 S Mcclintock Dr #100 Tempe AZ 85282-7376 | |
| (480) 820-1133 | |
| Not Available |
| Full Name | East Valley Primary Care Physicians Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 4515 S Mcclintock Dr, Tempe, Arizona |
| Authorized Official Name and Position | Flora Camacho (OFFICE MANAGER) |
| Authorized Official Contact | 4808201133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Valley Primary Care Physicians Plc 4515 S Mcclintock Dr #100 Tempe AZ 85282-7376 Ph: (480) 820-1133 | East Valley Primary Care Physicians Plc 4515 S Mcclintock Dr #100 Tempe AZ 85282-7376 Ph: (480) 820-1133 |
| NPI Number | 1538177449 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 10/05/2010 |
| Medicare PECOS PAC ID | 2860471893 |
|---|---|
| Medicare Enrollment ID | O20040714001217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538177449 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | James L Blair |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780631044 PECOS PAC ID: 5395750368 Enrollment ID: I20060310000361 |
| Provider Name | David J Mickus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871599688 PECOS PAC ID: 8224154299 Enrollment ID: I20100928000012 |
| Provider Name | Tracey L Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770589491 PECOS PAC ID: 7517159767 Enrollment ID: I20101026000366 |
| Provider Name | Regina M Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043216872 PECOS PAC ID: 5890987044 Enrollment ID: I20110224000490 |
| Provider Name | Sufia Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508271800 PECOS PAC ID: 6103137633 Enrollment ID: I20190617002059 |
| Provider Name | Tammy Lynn Tunis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447809926 PECOS PAC ID: 3779919949 Enrollment ID: I20200206001358 |
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East Valley Primary Care Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4515 S Mcclintock Dr, Ste 100, Tempe, AZ 85282 Phone: 480-820-1133 Fax: 480-820-9292 | |
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