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108 N Frontier St Wickenburg AZ 85390-4411 | |
(928) 684-7255 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 108 N Frontier St, Wickenburg, Arizona |
Authorized Official Name and Position | Thomas A Matlock (PRESIDENT) |
Authorized Official Contact | 9286847255 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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108 N Frontier Street Wickenburg AZ 85390-4411 Ph: (928) 684-7255 | 108 N Frontier St Wickenburg AZ 85390-4411 Ph: (928) 684-7255 |
NPI Number | 1063780583 |
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Provider Enumeration Date | 12/12/2011 |
Last Update Date | 01/30/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063780583 | NPI | - | NPPES |
203878 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | AZ4277 (Arizona) | Primary |
Anu Hospitalist Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 Rose Ln, Wickenburg, AZ 85390 Phone: 702-453-3799 | |
Miller Clinic Ltd Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 500 Savage St, Wickenburg, AZ 85390 Phone: 928-684-2425 Fax: 928-684-0387 | |