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General NPI Number Information
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NPI Number | 1790959393
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Entity Type | Organization
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Legal Business Name | ARIZONA INDEPENDENT MEDICAL ASSOCIATES, PLLC
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 05/16/2018
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Provider Practice Location Address
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Address Line | 3150 N WINDING BROOK RD
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-0972
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Country | US
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Telephone | 928-556-0060
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Fax | 928-556-0015
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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 | 928-556-0060
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Fax | 928-556-0015
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Authorized Official
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Title or Position | FNP/CO-OWNER
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Name | CHRISTINE M MCGREGOR
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Credential |
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Telephone | 928-556-0060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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