Provider Demographics
NPI:1346222106
Name:MONROY, CARRIE J (MD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:J
Last Name:MONROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4300 S LARIAT LOOP
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86005-2305
Mailing Address - Country:US
Mailing Address - Phone:928-853-5514
Mailing Address - Fax:928-774-5486
Practice Address - Street 1:452 N SWITZER CANYON DR
Practice Address - Street 2:STE A
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-4855
Practice Address - Country:US
Practice Address - Phone:928-779-1227
Practice Address - Fax:928-779-5884
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28534207Q00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ527830OtherAHCCCS
AZ527830OtherAHCCCS
AZ103066Medicare ID - Type Unspecified