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General NPI Number Information
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NPI Number | 1790017473
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Entity Type | Organization
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Legal Business Name | ARIZONA INDEPENDENT MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 02/05/2010
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Last Update Date | 02/05/2010
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Provider Practice Location Address
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Address Line | 505 JACKS CANYON RD
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City | SEDONA
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State | AZ
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Zip | 86351-7856
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Country | US
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Telephone | 928-773-0003
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Fax | 928-773-1170
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Provider Business Mailing Address
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Address Line | PO BOX 2277
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City | FLAGSTAFF
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State | AZ
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Zip | 86003-2277
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Country | US
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Telephone | 928-773-0003
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Fax | 928-773-1170
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Authorized Official
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Title or Position | MEMBER
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Name | DR. STEPHAN STELLMACHER
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Credential | D.O.
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Telephone | 928-773-0003
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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