| Mountain Avenue Clinic | |
|
606 N Main St Eagar AZ 85925-9813 | |
| (928) 333-5333 | |
| (928) 333-5100 |
| Full Name | Mountain Avenue Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 606 N Main St, Eagar, Arizona |
| Authorized Official Name and Position | Lori Lesueur (OFFICE MANAGER) |
| Authorized Official Contact | 9283335333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Avenue Clinic Po Box 1610 Springerville AZ 85938-1610 Ph: (928) 333-5333 | Mountain Avenue Clinic 606 N Main St Eagar AZ 85925-9813 Ph: (928) 333-5333 |
| NPI Number | 1790974830 |
|---|---|
| Provider Enumeration Date | 10/15/2007 |
| Last Update Date | 08/27/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790974830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 23187 (Arizona) | Primary |
Summit Healthcare Medical Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 606 N Main St, Eagar, AZ 85925 Phone: 928-333-5333 Fax: 928-333-5100 |