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General NPI Number Information
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NPI Number | 1063487486
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Entity Type | Individual
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Provider Name | RALPH ESKER MAYBERRY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/20/2006
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 1800 E WILCOX DR
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2756
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Country | US
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Telephone | 520-459-3116
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Fax | 520-459-7397
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Provider Business Mailing Address
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Address Line | 1800 E WILCOX DR FAMILY HEALTH CENTER OF SIERRA VISTA
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2756
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Country | US
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Telephone | 520-459-3116
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Fax | 520-459-7397
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 16890
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License Number State | AZ
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