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General NPI Number Information
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NPI Number | 1659621068
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Entity Type | Organization
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Legal Business Name | WEST MCDOWELL HEALTH CENTER PLLC
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 5030 W MCDOWELL RD STE 6
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City | PHOENIX
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State | AZ
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Zip | 85035-3946
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Country | US
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Telephone | 602-824-4900
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Fax | 602-824-4912
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Provider Business Mailing Address
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Address Line | 5030 W MCDOWELL RD STE 6
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City | PHOENIX
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State | AZ
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Zip | 85035-3946
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Country | US
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Telephone | 602-824-4900
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Fax | 602-824-4912
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Authorized Official
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Title or Position | PHYSICIAN
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Name | PATRICK HEENAN
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Credential | DO
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Telephone | 602-824-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 3051
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License Number State | AZ
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