| Fred S Markham Md Pc | |
|
804 Ainsworth Dr Suite 104 Prescott AZ 86301-1624 | |
| (928) 778-1736 | |
| (928) 717-0785 |
| Full Name | Fred S Markham Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 804 Ainsworth Dr, Prescott, Arizona |
| Authorized Official Name and Position | Fred S Markham (OWNER PRESIDENT) |
| Authorized Official Contact | 9287781736 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fred S Markham Md Pc Po Box 20490 Mesa AZ 85277-0490 Ph: () - | Fred S Markham Md Pc 804 Ainsworth Dr Suite 104 Prescott AZ 86301-1624 Ph: (928) 778-1736 |
| NPI Number | 1073545240 |
|---|---|
| Provider Enumeration Date | 07/07/2006 |
| Last Update Date | 10/02/2007 |
| Medicare PECOS PAC ID | 9830181262 |
|---|---|
| Medicare Enrollment ID | O20040402000952 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073545240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jean M Colella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902803208 PECOS PAC ID: 0840278123 Enrollment ID: I20040713000100 |
| Provider Name | Fred S Markham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679538995 PECOS PAC ID: 9931096062 Enrollment ID: I20050926001099 |
| Provider Name | Debra A Snow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477585727 PECOS PAC ID: 0941302723 Enrollment ID: I20070226000252 |
| Provider Name | Kimberly A Whitehill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407164767 PECOS PAC ID: 2961796693 Enrollment ID: I20160803001925 |
| Provider Name | Angela Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477917342 PECOS PAC ID: 3678846581 Enrollment ID: I20211013003722 |
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