| |
1040 Whipple St Suite 209 Prescott AZ 86305-1613 | |
(928) 776-6400 | |
(928) 776-6410 |
Full Name | |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 1040 Whipple St, Prescott, Arizona |
Authorized Official Name and Position | Dieter W. Krantz (VICE PRESIDENT) |
Authorized Official Contact | 9287722591 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
3051 N Windsong Dr Prescott Valley AZ 86314-2248 Ph: (928) 772-2500 | 1040 Whipple St Suite 209 Prescott AZ 86305-1613 Ph: (928) 776-6400 |
NPI Number | 1275526402 |
---|---|
Provider Enumeration Date | 08/23/2005 |
Last Update Date | 08/30/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275526402 | NPI | - | NPPES |
553653 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | 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 | |