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General NPI Number Information
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NPI Number | 1538371604
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Entity Type | Organization
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Legal Business Name | QUEEN CREEK PRIMARY CARE, P.C.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 01/15/2008
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Provider Practice Location Address
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Address Line | 20713 E. OCOTILLO ROAD #100
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City | QUEEN CREEK
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State | AZ
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Zip | 85242
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Country | US
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Telephone | 480-882-9993
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Fax | 480-248-2377
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Provider Business Mailing Address
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Address Line | 20713 E. OCOTILLO ROAD #100
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City | QUEEN CREEK
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State | AZ
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Zip | 85242
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Country | US
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Telephone | 480-882-9993
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Fax | 480-248-2377
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KIM HUNT
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Credential |
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Telephone | 480-248-2348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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