Krupnick Enhanced Medical Care | |
3181 Clearwater Dr Suite B Prescott AZ 86305-7196 | |
(928) 515-1755 | |
Not Available |
Full Name | Krupnick Enhanced Medical Care |
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Speciality | Clinic/Center |
Location | 3181 Clearwater Dr, Prescott, Arizona |
Authorized Official Name and Position | Kurt Andrew Krupnick (OWNER/PROVIDER) |
Authorized Official Contact | 9288996919 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Krupnick Enhanced Medical Care 4390 W Fort Bridger Rd Prescott AZ 86305-9038 Ph: (928) 899-6919 | Krupnick Enhanced Medical Care 3181 Clearwater Dr Suite B Prescott AZ 86305-7196 Ph: (928) 515-1755 |
NPI Number | 1154868867 |
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Provider Enumeration Date | 01/20/2017 |
Last Update Date | 01/20/2017 |
Medicare PECOS PAC ID | 7911281266 |
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Medicare Enrollment ID | O20170303002023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154868867 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 42104 (Arizona) | Primary |
Provider Name | Kurt A Krupnick |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1700836129 PECOS PAC ID: 8426157090 Enrollment ID: I20090721000023 |
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