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General NPI Number Information
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NPI Number | 1497740187
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Entity Type | Organization
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Legal Business Name | GILA HEALTH RESOURCES
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 401 BURRO ALY
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City | MORENCI
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State | AZ
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Zip | 85540-9647
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Country | US
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Telephone | 928-865-7502
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Fax | 928-865-9186
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Provider Business Mailing Address
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Address Line | PO BOX 218
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City | MORENCI
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State | AZ
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Zip | 85540-0218
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Country | US
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Telephone | 928-865-7500
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Fax | 928-865-9186
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS OPERATIONS
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Name | KRISTY BYRD
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Credential |
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Telephone | 928-965-7518
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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 | OTC3507
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License Number State | AZ
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