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General NPI Number Information
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NPI Number | 1477818730
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Entity Type | Organization
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Legal Business Name | TRI-CITY EXPRESS CARE, PLLC
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 940 E. UNIVERSITY DRIVE SUITE 101
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City | TEMPE
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State | AZ
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Zip | 85281-4278
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Country | US
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Telephone | 480-214-0622
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Fax | 480-361-1104
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Provider Business Mailing Address
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Address Line | 890 W ELLIOT RD SUITE 103
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City | GILBERT
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State | AZ
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Zip | 85233-5102
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Country | US
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Telephone | 480-545-2787
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Fax | 480-545-1434
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Authorized Official
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Title or Position | CMO/CEO
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Name | DR. MICHAEL P DUNN
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Credential | MD
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Telephone | 480-545-2787
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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 | AZ
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | OTC5449
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License Number State | AZ
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