WILLOW VALLEY MEDICAL CENTER PC NPI 1134111834

NPI Information

NPI: 1134111834
Provider Name: WILLOW VALLEY MEDICAL CENTER PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
8700 HIGHWAY 95
MOHAVE VALLEY, AZ
ZIP 86440
Phone: (760) 217-2464
Get Directions

WILLOW VALLEY MEDICAL CENTER PC is a family medicine in Mohave Valley, AZ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WILLOW VALLEY MEDICAL CENTER PC NPI is 1134111834. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

8700 HIGHWAY 95
MOHAVE VALLEY, AZ
ZIP 86440-519
Phone: (760) 217-2464
Fax: (928) 453-9207

The provider's authorized official is Donovan J Anderson .
The authorized official title is Physician and has the following contact phone number (760) 217-2464.

The enumeration date for this NPI number is 8/18/2005 and was last updated on 2/8/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		13491	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DI935A	OTHER	CALIFORNIA	MEDICARE PTAN
2	XPY055881	MEDICAID	CALIFORNIA
3	AZ0325100	OTHER	ARIZONA	AZ BCBS
4	205288-002	MEDICAID	ARIZONA
5	205288-01	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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