Provider Demographics
NPI:1801041264
Name:CHOICE MEDICAL WALK IN PLLC
Entity Type:Organization
Organization Name:CHOICE MEDICAL WALK IN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:FOY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:623-326-9588
Mailing Address - Street 1:39612 N BELFAIR WAY
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3663
Mailing Address - Country:US
Mailing Address - Phone:623-551-5635
Mailing Address - Fax:
Practice Address - Street 1:12262 E BRADSHAW MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:DEWEY
Practice Address - State:AZ
Practice Address - Zip Code:86327-6032
Practice Address - Country:US
Practice Address - Phone:928-772-1673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3834261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care