Provider Demographics
NPI:1801836689
Name:CHOICES INTEGRATIVE HEALTH CARE
Entity Type:Organization
Organization Name:CHOICES INTEGRATIVE HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MIKLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-203-4844
Mailing Address - Street 1:95 SOLDIERS PASS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-4781
Mailing Address - Country:US
Mailing Address - Phone:928-203-4863
Mailing Address - Fax:928-203-4497
Practice Address - Street 1:95 SOLDIERS PASS RD
Practice Address - Street 2:SUITE B
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-4781
Practice Address - Country:US
Practice Address - Phone:928-203-4863
Practice Address - Fax:928-203-4497
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHOICES INTEGRATIVE HEALTH CARE OF SEDONA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-08
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27754207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ83492Medicare PIN