Provider Demographics
NPI:1265904247
Name:PRIMARY CARE PRACTICE OF ARIZONA, PLLC
Entity type:Organization
Organization Name:PRIMARY CARE PRACTICE OF ARIZONA, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-499-0201
Mailing Address - Street 1:21388 E ORION WAY
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6814
Mailing Address - Country:US
Mailing Address - Phone:480-650-8133
Mailing Address - Fax:
Practice Address - Street 1:920 E WILLIAMS FIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-4880
Practice Address - Country:US
Practice Address - Phone:480-650-8133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-01
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care