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General NPI Number Information
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NPI Number | 1750273371
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Entity Type | Organization
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Legal Business Name | FLAGSTAFF PULMONOLOGY PLLC
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 2501 N 4TH ST STE 21
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-3701
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Country | US
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Telephone | 847-942-2703
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Fax |
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Provider Business Mailing Address
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Address Line | 509 W PHILOMENA DR
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1334
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAJIV A PATEL
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Credential | MD
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Telephone | 847-942-2703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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