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General NPI Number Information
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NPI Number | 1588044457
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Entity Type | Organization
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Legal Business Name | FIRST CLASS MEDICAL CENTERS, PC
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2040 W BETHANY HOME RD
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City | PHOENIX
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State | AZ
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Zip | 85015-2473
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Country | US
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Telephone | 480-577-9340
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 W BETHANY HOME RD
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City | PHOENIX
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State | AZ
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Zip | 85015-2473
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Country | US
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Telephone | 480-577-9340
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. PATRICIA S SULLIVAN
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Credential | M.D
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Telephone | 480-577-9340
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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 | 40062
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License Number State | AZ
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