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General NPI Number Information
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NPI Number | 1376996868
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Entity Type | Organization
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Legal Business Name | STETSON HILLS FAMILY MEDICINE PLC
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Dates
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Enumeration Date | 07/20/2016
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Last Update Date | 07/20/2016
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Provider Practice Location Address
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Address Line | 41125 N DAISY MOUNTAIN DR STE. 109
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City | ANTHEM
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State | AZ
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Zip | 85086-4954
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Country | US
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Telephone | 623-594-6866
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Fax | 623-249-4982
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Provider Business Mailing Address
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Address Line | 6520 W HAPPY VALLEY RD STE. B-103
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City | GLENDALE
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State | AZ
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Zip | 85310-2615
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Country | US
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Telephone | 623-825-3700
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Fax | 623-825-7601
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Authorized Official
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Title or Position | OWNER
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Name | ERIC S LIMKEMANN
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Credential | D.O.
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Telephone | 623-825-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP8736
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5368
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License Number State | AZ
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