Healthcare Provider Details

I. General information

NPI: 1134382211
Provider Name (Legal Business Name): TUBA CITY REGIONAL HEALTH CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HIGHWAY 89 NORTH AT THE 466 MILE MARKER 1/8 MILE N OF CAMERON CHAPTER HOUSE
CAMERON AZ
86020
US

IV. Provider business mailing address

PO BOX 600
TUBA CITY AZ
86045-0600
US

V. Phone/Fax

Practice location:
  • Phone: 928-283-2672
  • Fax: 928-283-2677
Mailing address:
  • Phone: 928-283-2501
  • Fax: 928-283-2677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOETTE WALTERS
Title or Position: CEO
Credential:
Phone: 928-283-2147