| Mckellips Family Medical Clinic, Pllc | |
|
3514 N Power Rd Bldg. 1, Suite 105 Mesa AZ 85215-8521 | |
| (480) 422-8533 | |
| Not Available |
| Full Name | Mckellips Family Medical Clinic, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3514 N Power Rd, Mesa, Arizona |
| Authorized Official Name and Position | Carl Ferguson (PROVIDER) |
| Authorized Official Contact | 4808301553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mckellips Family Medical Clinic, Pllc 3514 N Power Rd Ste 105 Mesa AZ 85215-2907 Ph: (480) 422-8533 | Mckellips Family Medical Clinic, Pllc 3514 N Power Rd Bldg. 1, Suite 105 Mesa AZ 85215-8521 Ph: (480) 422-8533 |
| NPI Number | 1659787497 |
|---|---|
| Provider Enumeration Date | 07/01/2014 |
| Last Update Date | 11/01/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659787497 | NPI | - | NPPES |
| 273665 | Medicaid | AZ | |
| 7200350001 | Other | AZ | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
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