Healthcare Provider Details

I. General information

NPI: 1679990212
Provider Name (Legal Business Name): TRI-CITY EXPRESS CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2014
Last Update Date: 03/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8260 W INDIAN SCHOOL RD SUITE 1
PHOENIX AZ
85033-2980
US

IV. Provider business mailing address

890 W ELLIOT RD SUITE 103
GILBERT AZ
85233-5102
US

V. Phone/Fax

Practice location:
  • Phone: 623-846-7122
  • Fax: 623-846-7027
Mailing address:
  • Phone: 480-545-2787
  • Fax: 919-882-9575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberOTC2677
License Number StateAZ

VIII. Authorized Official

Name: DR. MICHAEL P DUNN
Title or Position: PRESIDENT/CMO
Credential: MD
Phone: 480-545-2787