BILLY CREEK CLINIC NPI 1679730493

NPI Information

  • NPI: 1679730493
  • Provider Name: BILLY CREEK CLINIC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 03D2012303
  • Address: 43 W WHITE MOUNTAIN BLVD
    LAKESIDE, AZ
    ZIP 85929
  • Phone: (928) 367-4040

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NPI Details

BILLY CREEK CLINIC is a primary care clinic center in Lakeside, AZ. BILLY CREEK CLINIC NPI is 1679730493. The provider is registered as an organization entity type.

The provider's business location address is:

43 W WHITE MOUNTAIN BLVD
LAKESIDE, AZ
ZIP 85929-002
Phone: (928) 367-4040
Fax: (928) 367-4042

The provider's authorized official is Jennifer L Larue .
The authorized official title is Billing and has the following contact phone number (928) 333-5333.

The CLIA number assigned to this NPI record is 03D2012303 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/20/2008 and was last updated on 5/27/2008.

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
1261QP2300XClinic/CenterPrimary Care32794ARIZONAYes

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: 11/21/2025

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