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General NPI Number Information
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NPI Number | 1932156437
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VIEW FAMILY MEDICINE PC
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | 122 E MAIN ST
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City | PAYSON
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State | AZ
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Zip | 85541-5646
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Country | US
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Telephone | 928-474-2888
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Fax | 928-474-2992
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Provider Business Mailing Address
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Address Line | 122 E MAIN ST
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City | PAYSON
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State | AZ
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Zip | 85541-5646
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Country | US
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Telephone | 928-474-2888
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Fax | 928-474-2992
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Authorized Official
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Title or Position | CO-PRESIDENT
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Name | DR. KAREN FRAYSER EVANS
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Credential | D. O.
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Telephone | 928-474-2888
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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 | 3727
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License Number State | AZ
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