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General NPI Number Information
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NPI Number | 1205084324
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Entity Type | Organization
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Legal Business Name | ARIZONA AVE EMERGENCY PHYSICIANS
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 200 E ARIZONA AVE
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City | SWEETWATER
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State | TX
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Zip | 79556-7120
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Country | US
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Telephone | 325-235-1701
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Fax | 800-305-3233
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Provider Business Mailing Address
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Address Line | PO BOX 98625
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City | LAS VEGAS
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State | NV
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Zip | 89193
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Country | US
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Telephone | 800-444-7009
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Fax | 800-305-3233
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH H GATEWOOD
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Credential | MD
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Telephone | 800-527-2145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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