Healthcare Provider Details

I. General information

NPI: 1184982597
Provider Name (Legal Business Name): GLOBAL PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 07/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 N 2ND ST SUITE 213
PHOENIX AZ
85020-2446
US

IV. Provider business mailing address

6245 N 16TH ST
PHOENIX AZ
85016-1706
US

V. Phone/Fax

Practice location:
  • Phone: 602-792-5769
  • Fax:
Mailing address:
  • Phone: 602-792-5769
  • Fax: 602-253-4273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateAZ

VIII. Authorized Official

Name: LESLIE M DIGGES
Title or Position: OFFICE MANAGER
Credential:
Phone: 602-308-7822