Leon A Driss Pc | |
5300 S Sutter Dr Ste 12 Show Low AZ 85901-8055 | |
(928) 251-2541 | |
(833) 450-5183 |
Full Name | Leon A Driss Pc |
---|---|
Speciality | Internal Medicine |
Location | 5300 S Sutter Dr Ste 12, Show Low, Arizona |
Authorized Official Name and Position | Chris Brown (MGR) |
Authorized Official Contact | 9285371077 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Leon A Driss Pc Po Box 888 Lakeside AZ 85929-0888 Ph: (928) 251-2541 | Leon A Driss Pc 5300 S Sutter Dr Ste 12 Show Low AZ 85901-8055 Ph: (928) 251-2541 |
NPI Number | 1770500530 |
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Provider Enumeration Date | 07/17/2006 |
Last Update Date | 06/18/2024 |
Medicare PECOS PAC ID | 2860481033 |
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Medicare Enrollment ID | O20040511001652 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770500530 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Leon A Driss |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1669445706 PECOS PAC ID: 4385531516 Enrollment ID: I20051103000015 |
Provider Name | Michele Mccormick |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588199160 PECOS PAC ID: 3072882158 Enrollment ID: I20170705001856 |
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