| Southwest I.d. & Medical Clinic, Lc | |
|
3235 N Windsong Dr Prescott Valley AZ 86314-1222 | |
| (928) 772-3340 | |
| (928) 759-9611 |
| Full Name | Southwest I.d. & Medical Clinic, Lc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3235 N Windsong Dr, Prescott Valley, Arizona |
| Authorized Official Name and Position | Alpana Jetly (MANAGER) |
| Authorized Official Contact | 9287723340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest I.d. & Medical Clinic, Lc Po Box 1629 Prescott AZ 86302-1629 Ph: (928) 772-3340 | Southwest I.d. & Medical Clinic, Lc 3235 N Windsong Dr Prescott Valley AZ 86314-1222 Ph: (928) 772-3340 |
| NPI Number | 1275563975 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 09/07/2023 |
| Medicare PECOS PAC ID | 9739192246 |
|---|---|
| Medicare Enrollment ID | O20060731000415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275563975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 29064 (Arizona) | Primary |
| Provider Name | Rajiv Jetly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861494247 PECOS PAC ID: 3779596184 Enrollment ID: I20060801000298 |
| Provider Name | Angela Marie Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316454994 PECOS PAC ID: 8426318999 Enrollment ID: I20180131001707 |
Yavapai Regional Medical Center Physician Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7700 E Florentine Rd Bldg B, Suite A101, Prescott Valley, AZ 86314 Phone: 928-442-8710 Fax: 928-442-8742 | |
Vasco Healthcare Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 N Navajo Dr Ste B3, Prescott Valley, AZ 86314 Phone: 602-346-0204 | |
Shirley Rheinfelder Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3149 N Windsong Dr, Prescott Valley, AZ 86314 Phone: 928-445-6083 Fax: 928-775-2307 | |
Michael J Bryan Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3251 N Windsong Dr, Prescott Valley, AZ 86314 Phone: 928-772-2582 Fax: 928-772-2383 | |
Robert Sinsheimer Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3251 N Windsong Dr, Prescott Valley, AZ 86314 Phone: 928-772-2582 Fax: 928-772-2383 | |
Arizona Heart Institute Prescott Valley Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3188 N Windsong Dr, Suite B, Prescott Valley, AZ 86314 Phone: 928-772-8217 Fax: 928-778-3026 | |
Mary E. Moyer Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3251 N Windsong Dr, Prescott Valley, AZ 86314 Phone: 928-772-2582 Fax: 928-772-2383 |