| |
811 Ainsworth Dr Ste 103 Prescott AZ 86301-1687 | |
(928) 771-5548 | |
(928) 771-5549 |
Full Name | |
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Speciality | Internal Medicine - Gastroenterology |
Location | 811 Ainsworth Dr Ste 103, Prescott, Arizona |
Authorized Official Name and Position | Debbie Marie De Luna (OFFICE MANAGER) |
Authorized Official Contact | 9287715548 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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811 Ainsworth Dr Ste 103 Prescott AZ 86301-1687 Ph: (928) 771-5548 | 811 Ainsworth Dr Ste 103 Prescott AZ 86301-1687 Ph: (928) 771-5548 |
NPI Number | 1720110984 |
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Provider Enumeration Date | 03/12/2007 |
Last Update Date | 08/27/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720110984 | NPI | - | NPPES |
176950 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | 22747 (Arizona) | Primary |
Ellen F Bunch Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1456 W Gurley St, Prescott, AZ 86305 Phone: 928-777-8880 Fax: 928-777-8884 | |
Fred S Markham Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 804 Ainsworth Dr, Suite 104, Prescott, AZ 86301 Phone: 928-778-1736 Fax: 928-717-0785 | |
Yavapai Regional Medical Center Physician Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 726 Gail Gardner Way, Suite B, Prescott, AZ 86305 Phone: 928-445-0304 | |