Provider Demographics
NPI:1235504838
Name:DYER HEALTH PLLC
Entity Type:Organization
Organization Name:DYER HEALTH PLLC
Other - Org Name:THE BEN-ASHER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:E
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:520-203-9547
Mailing Address - Street 1:11200 S SIERRITA MOUNTAIN RD
Mailing Address - Street 2:BOX #146
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85736-1434
Mailing Address - Country:US
Mailing Address - Phone:520-888-3032
Mailing Address - Fax:800-330-0592
Practice Address - Street 1:2001 W ORANGE GROVE RD STE 416
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1141
Practice Address - Country:US
Practice Address - Phone:520-888-3032
Practice Address - Fax:800-330-0592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ100622Medicaid
AZ100622Medicaid