Fountain Hills Primary Care Llc | |
16857 E Saguaro Blvd Fountain Hills AZ 85268-6616 | |
(480) 626-9578 | |
(920) 214-1167 |
Full Name | Fountain Hills Primary Care Llc |
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Speciality | Clinic/Center |
Location | 16857 E Saguaro Blvd, Fountain Hills, Arizona |
Authorized Official Name and Position | Dylan Doss (CEO) |
Authorized Official Contact | 4806269578 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fountain Hills Primary Care Llc 16857 E Saguaro Blvd Fountain Hills AZ 85268-6616 Ph: (480) 626-9578 | Fountain Hills Primary Care Llc 16857 E Saguaro Blvd Fountain Hills AZ 85268-6616 Ph: (480) 626-9578 |
NPI Number | 1649926536 |
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Provider Enumeration Date | 03/01/2022 |
Last Update Date | 03/01/2022 |
Medicare PECOS PAC ID | 1658768817 |
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Medicare Enrollment ID | O20220419000482 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649926536 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Dylan S Doss |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1609308006 PECOS PAC ID: 0244563419 Enrollment ID: I20220419000597 |
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