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General NPI Number Information
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NPI Number | 1831383603
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Entity Type | Organization
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Legal Business Name | ARIZONA ON CALL HEALTH
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Dates
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Enumeration Date | 09/05/2007
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Last Update Date | 09/05/2007
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Provider Practice Location Address
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Address Line | 2426 W KIOWA AVE
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City | MESA
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State | AZ
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Zip | 85202-6380
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Country | US
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Telephone | 480-456-5022
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Fax | 480-820-7339
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Provider Business Mailing Address
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Address Line | 2426 W KIOWA AVE
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City | MESA
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State | AZ
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Zip | 85202-6380
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Country | US
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Telephone | 480-456-5022
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Fax | 480-820-7339
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Authorized Official
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Title or Position | C.E.O.
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Name | LORI J WALTER
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Credential |
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Telephone | 480-456-5022
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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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