Healthcare Provider Details

I. General information

NPI: 1912234295
Provider Name (Legal Business Name): ABSHIRE INTERNAL MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2009
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 E JACOB WALTZ ST
APACHE JUNCTION AZ
85119-9450
US

IV. Provider business mailing address

5325 E JACOB WALTZ ST
APACHE JUNCTION AZ
85119-9450
US

V. Phone/Fax

Practice location:
  • Phone: 480-463-4022
  • Fax:
Mailing address:
  • Phone: 480-463-4022
  • Fax: 480-302-5242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number32271
License Number StateAZ

VIII. Authorized Official

Name: DR. VANCE ABSHIRE
Title or Position: PRESIDENT
Credential: MD
Phone: 480-463-4022