MAIN STREET FAMILY MEDICAL INC. NPI 1386837763

NPI Information

MAIN STREET FAMILY MEDICAL, INC. is a primary care clinic center in Safford, AZ. MAIN STREET FAMILY MEDICAL, INC. NPI is 1386837763. The provider is registered as an organization entity type.

The provider's business location address is:

500 W MAIN ST
SAFFORD, AZ
ZIP 85546-727
Phone: (192) 834-8710
Fax: (928) 348-7813

The provider's authorized official is Tiffany A Scott .
The authorized official title is Owner and has the following contact phone number (928) 348-7100.

The CLIA number assigned to this NPI record is 03D1070612 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/20/2007 and was last updated on 8/20/2007.

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:

Other Identifiers

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

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