MEDICARE: APACHE PLUME HEALTHCARE ASSOCIATES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1861431843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APACHE PLUME HEALTHCARE ASSOCIATES PC

Provider Business Mailing Address
First Line	:	PO BOX 52890
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85208-0145
Country	:	US
Telephone Number	:	480-357-8411
Fax Number	:	480-357-8532

Provider Business Practice Location Address
First Line	:	2080 W SOUTHERN AVE
Second Line	:	STE A2
City	:	APACHE JUNCTION
State	:	AZ
Zip	:	85220-7455
Country	:	US
Telephone Number	:	480-357-8411
Fax Number	:	480-357-8532

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TOMMY CARL LEEPER
Credential	:	MD
Telephone Number	:	480-357-8411

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	09/11/2025

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