| Grand Canyon Family Medicine Pc | |
|
3960 E Riggs Rd Suite 1 Chandler AZ 85249-5410 | |
| (480) 786-4441 | |
| (480) 786-4609 |
| Full Name | Grand Canyon Family Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 3960 E Riggs Rd, Chandler, Arizona |
| Authorized Official Name and Position | Robert M Tognacci (OWNER) |
| Authorized Official Contact | 4807864441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Canyon Family Medicine Pc 3960 E Riggs Rd Suite 1 Chandler AZ 85249-5410 Ph: (480) 786-4441 | Grand Canyon Family Medicine Pc 3960 E Riggs Rd Suite 1 Chandler AZ 85249-5410 Ph: (480) 786-4441 |
| NPI Number | 1164510616 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 07/12/2024 |
| Medicare PECOS PAC ID | 5294839940 |
|---|---|
| Medicare Enrollment ID | O20070405000189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164510616 | NPI | - | NPPES |
| 362513 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Arizona) | Primary |
| Provider Name | Paula F Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073735767 PECOS PAC ID: 0244134534 Enrollment ID: I20031119000774 |
| Provider Name | Mary A Quihuis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306978333 PECOS PAC ID: 8820996895 Enrollment ID: I20031229000693 |
| Provider Name | Lorretta K Mccarthy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033126248 PECOS PAC ID: 6800798091 Enrollment ID: I20040127000597 |
| Provider Name | Robert M Tognacci |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669404711 PECOS PAC ID: 2860495256 Enrollment ID: I20060825000204 |
| Provider Name | Sara Ann Kneuss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316096449 PECOS PAC ID: 9133227374 Enrollment ID: I20070612000090 |
| Provider Name | Robin Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184142218 PECOS PAC ID: 7214298728 Enrollment ID: I20180226000854 |
| Provider Name | Alexander Plado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366007700 PECOS PAC ID: 6305179961 Enrollment ID: I20190613001180 |
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