GERALD J TAITAGUE MD PC NPI 1689813834

NPI Information

  • NPI: 1689813834
  • Provider Name: GERALD J TAITAGUE MD PC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: EAGLE ROCK HEALTH CLINC
  • Address: 117 W ROUTE 66
    SUITE 190
    WILLIAMS, AZ
    ZIP 86046
  • Phone: (928) 635-1044

Map and Directions

Get Directions

NPI Details

GERALD J TAITAGUE MD PC is a primary care clinic center in Williams, AZ. GERALD J TAITAGUE MD PC NPI is 1689813834. The provider is registered as an organization entity type.
The provider Is Doing Business As Eagle Rock Health Clinc.

The provider's business location address is:

117 W ROUTE 66
SUITE 190
WILLIAMS, AZ
ZIP 86046-567
Phone: (928) 635-1044
Fax: (928) 635-1042

The provider's authorized official is Gerald J Taitague .
The authorized official title is President/physician and has the following contact phone number (928) 635-1044.

The enumeration date for this NPI number is 2/11/2009 and was last updated on 2/11/2009.

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 Care26182ARIZONAYes

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
1G67639MEDICARE UPINARIZONA
2AZ0865880OTHERARIZONABLUE CROSS
361893MEDICARE PINARIZONA
401-0064151OTHERARIZONARAILROAD MEDICARE
5426503OTHERARIZONAAHCCCS

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI