| Innovation Medical Pllc | |
|
3914 N Campbell Ave Tucson AZ 85719-1428 | |
| (520) 260-1181 | |
| (949) 655-5887 |
| Full Name | Innovation Medical Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3914 N Campbell Ave, Tucson, Arizona |
| Authorized Official Name and Position | Crysty Frick (OWNER) |
| Authorized Official Contact | 5207802533 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovation Medical Pllc 5335 W Avenida Tierra Alta Tucson AZ 85742-4194 Ph: (520) 780-2533 | Innovation Medical Pllc 3914 N Campbell Ave Tucson AZ 85719-1428 Ph: (520) 260-1181 |
| NPI Number | 1205526837 |
|---|---|
| Provider Enumeration Date | 05/08/2023 |
| Last Update Date | 05/08/2023 |
| Medicare PECOS PAC ID | 9234598103 |
|---|---|
| Medicare Enrollment ID | O20230711000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205526837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Crysty L Frick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396010823 PECOS PAC ID: 3476717802 Enrollment ID: I20120614000233 |
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