| Family Medicine At Bison Ranch | |
|
2352 Quarter Horse Trail Overgaard AZ 85933 | |
| (928) 535-3616 | |
| (928) 532-2156 |
| Full Name | Family Medicine At Bison Ranch |
|---|---|
| Speciality | Clinic/Center |
| Location | 2352 Quarter Horse Trail, Overgaard, Arizona |
| Authorized Official Name and Position | Jill Bluse (HEALTH PLAN CREDENTIALING COORDINAT) |
| Authorized Official Contact | 9285376393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine At Bison Ranch Po Box 1013 Overgaard AZ 85933-1013 Ph: (928) 535-3616 | Family Medicine At Bison Ranch 2352 Quarter Horse Trail Overgaard AZ 85933 Ph: (928) 535-3616 |
| NPI Number | 1770700767 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 05/17/2023 |
| Medicare PECOS PAC ID | 8729205737 |
|---|---|
| Medicare Enrollment ID | O20190104001647 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770700767 | NPI | - | NPPES |
| 950222 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | H0132 (Arizona) | Primary |
Compass Medical Center Heber, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2931 Highway 260, Overgaard, AZ 85933 Phone: 928-536-5525 Fax: 928-536-3735 | |
Mitchell F Horan Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2931 Arizona Hwy 260, Overgaard, AZ 85933 Phone: 928-535-3616 Fax: 928-535-3615 |