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COPPER QUEEN MEDICAL ASSOCIATES DOUGLAS NPI 1942217088


NPI Information

NPI: 1942217088
Provider Name: COPPER QUEEN MEDICAL ASSOCIATES DOUGLAS
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 03D2124326

Address:
100 E 5TH ST
DOUGLAS, AZ
ZIP 85607
Phone: (520) 364-7659
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COPPER QUEEN MEDICAL ASSOCIATES DOUGLAS is a clinic center in Douglas, AZ. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). COPPER QUEEN MEDICAL ASSOCIATES DOUGLAS NPI is 1942217088. The provider is registered as an organization entity type.

The provider's business location address is:

100 E 5TH ST
DOUGLAS, AZ
ZIP 85607-859
Phone: (520) 364-7659
Fax: (520) 364-8541

The provider's authorized official is Betty Jo Carrizoza .
The authorized official title is Office Manager and has the following contact phone number (520) 364-7659.

The CLIA number assigned to this NPI record is 03D2124326 - other with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/2/2006 and was last updated on 8/8/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterOTC-3364ARIZONAYes

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: 11/14/2023

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.