MEDICARE: VALLEY VIEW PHYSICIAN PRACTICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	2086S0102X	Surgical Critical Care Physician
2	2086S0129X	Vascular Surgery Physician
3	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1144455478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY VIEW PHYSICIAN PRACTICES LLC

Provider Business Mailing Address
First Line	:	5300 S HIGHWAY 95
Second Line	:	SUITE K
City	:	FORT MOHAVE
State	:	AZ
Zip	:	86426-9251
Country	:	US
Telephone Number	:	928-768-4499
Fax Number	:	928-768-6499

Provider Business Practice Location Address
First Line	:	5300 S HIGHWAY 95
Second Line	:	SUITE K
City	:	FORT MOHAVE
State	:	AZ
Zip	:	86426-9251
Country	:	US
Telephone Number	:	928-768-4499
Fax Number	:	928-768-6499

Authorized Official
Title or Position	:	SECRETARY
Name	:	CHARLOTTE E LAWRENCE
Credential	:
Telephone Number	:	615-920-7000

Provider Enumeration Date	:	05/15/2009
Last Update Date	:	01/12/2025

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