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General NPI Number Information
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NPI Number | 1194977520
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Entity Type | Organization
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Legal Business Name | YUMA HEART AND MEDICAL INSTITUTE PLLC
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 2503 S AVENUE A STE 2
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City | YUMA
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State | AZ
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Zip | 85364-7173
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Country | US
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Telephone | 928-344-3350
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Fax | 928-344-2270
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Provider Business Mailing Address
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Address Line | 2503 S AVENUE A SUITE 2
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City | YUMA
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State | AZ
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Zip | 85364-7173
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Country | US
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Telephone | 928-344-3350
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Fax | 928-344-2270
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MOLLY PAYNE
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Credential |
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Telephone | 928-344-3350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 19608
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 34512
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 35717
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License Number State | AZ
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