| Healthy Outlook Family Medicine, Pc | |
|
1835 W Missouri Ave Phoenix AZ 85015-3046 | |
| (602) 230-0777 | |
| (602) 230-0008 |
| Full Name | Healthy Outlook Family Medicine, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1835 W Missouri Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Susan Whitely (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6022300777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Outlook Family Medicine, Pc 1835 W Missouri Ave Phoenix AZ 85015-3046 Ph: (602) 230-0777 | Healthy Outlook Family Medicine, Pc 1835 W Missouri Ave Phoenix AZ 85015-3046 Ph: (602) 230-0777 |
| NPI Number | 1023161825 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 04/18/2023 |
| Medicare PECOS PAC ID | 2466344023 |
|---|---|
| Medicare Enrollment ID | O20040327000316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023161825 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mark C Luba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437139813 PECOS PAC ID: 4284668260 Enrollment ID: I20050920000280 |
| Provider Name | Susan Mary Whitely |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427013762 PECOS PAC ID: 7719879378 Enrollment ID: I20101005000240 |
| Provider Name | Dawn Leah Cohen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033174248 PECOS PAC ID: 7810182227 Enrollment ID: I20101111000357 |
| Provider Name | Sara Chavez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619598687 PECOS PAC ID: 1456774843 Enrollment ID: I20200701002005 |
| Provider Name | Jennifer Renae Reale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386228658 PECOS PAC ID: 2860892130 Enrollment ID: I20210609000621 |
| Provider Name | Kimberly A Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518699479 PECOS PAC ID: 9133503014 Enrollment ID: I20220825003127 |
| Provider Name | Lisa Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316725161 PECOS PAC ID: 4880043355 Enrollment ID: I20231208001654 |
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