| Ponderosa Family Care, Llc | |
|
127 E Main St Ste D Payson AZ 85541-5646 | |
| (928) 468-8603 | |
| (928) 468-8625 |
| Full Name | Ponderosa Family Care, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 127 E Main St Ste D, Payson, Arizona |
| Authorized Official Name and Position | Alan P Michels (PHYSICIAN/OWNER) |
| Authorized Official Contact | 9284688603 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ponderosa Family Care, Llc Po Box 2901 Payson AZ 85547-2901 Ph: (928) 468-8603 | Ponderosa Family Care, Llc 127 E Main St Ste D Payson AZ 85541-5646 Ph: (928) 468-8603 |
| NPI Number | 1992321723 |
|---|---|
| Provider Enumeration Date | 06/17/2020 |
| Last Update Date | 06/17/2020 |
| Medicare PECOS PAC ID | 1456548015 |
|---|---|
| Medicare Enrollment ID | O20200820002361 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992321723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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