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NPI Code Detail

MEDICARE: MATTHEW LYNN MCELROY PA-C

MEDICARE: MATTHEW LYNN MCELROY PA-C
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician8767AZ

General Provider Information

NPI Number : 1225685118
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW LYNN MCELROY PA-C
Provider Business Mailing Address
First Line : 19251 E OASIS DR
Second Line :
City : BLACK CANYON CITY
State : AZ
Zip : 85324-8878
Country : US
Telephone Number : 623-374-0200
Fax Number :
Provider Business Practice Location Address
First Line : 19251 E OASIS DR
Second Line :
City : BLACK CANYON CITY
State : AZ
Zip : 85324-8878
Country : US
Telephone Number : 623-374-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2019
Last Update Date : 10/14/2021

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