PROVIDER PROVIDER PC NPI 1760969190

NPI Information

PROVIDER PROVIDER PC is a general practice in Mesa, AZ. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee PROVIDER PROVIDER PC NPI is 1760969190. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

841 W 11TH ST
MESA, AZ
ZIP 85201-109
Phone: (480) 461-9822

The provider's authorized official is Jonathan Harris .
The authorized official title is Pa-c/member Of Corporation and has the following contact phone number (480) 461-9822.

The enumeration date for this NPI number is 7/28/2018 and was last updated on 12/20/2018.

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:

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.