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General NPI Number Information
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NPI Number | 1326130402
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Entity Type | Organization
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Legal Business Name | NORTHWEST FAMILY PRACTICE, P.C.
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 1521 E TANGERINE SUITE 131
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City | ORO VALLEY
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State | AZ
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Zip | 85755
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Country | US
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Telephone | 520-825-5719
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Fax | 520-825-9667
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Provider Business Mailing Address
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Address Line | 1521 E TANGERINE SUITE 131
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City | ORO VALLEY
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State | AZ
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Zip | 85755
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Country | US
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Telephone | 520-825-5719
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Fax | 520-825-9667
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Authorized Official
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Title or Position | DIRECTOR
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Name | ROBERTA HINDENLANG
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Credential | D.O
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Telephone | 520-825-5719
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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 |
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License Number State |
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