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General NPI Number Information
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NPI Number | 1003008889
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Entity Type | Organization
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Legal Business Name | MEDICAL CLINIC OF OAK CREEK INC
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 08/15/2007
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Provider Practice Location Address
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Address Line | 2301 W HWY 89A STE 107
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City | SEDONA
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State | AZ
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Zip | 86336
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Country | US
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Telephone | 928-203-9013
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Fax | 928-203-9016
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Provider Business Mailing Address
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Address Line | 2301 W HWY 89A STE 107
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City | SEDONA
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State | AZ
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Zip | 86336
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Country | US
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Telephone | 928-203-9013
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Fax | 928-203-9016
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JAMES M HUTTON JR.
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Credential | NMD
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Telephone | 928-203-9013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 93437
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 93437
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License Number State | AZ
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