Provider Demographics
NPI:1801069133
Name:DIFILIPPO, MARY REBECCA (NMD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:REBECCA
Last Name:DIFILIPPO
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1005
Mailing Address - Street 2:
Mailing Address - City:SPRINGERVILLE
Mailing Address - State:AZ
Mailing Address - Zip Code:85938-1005
Mailing Address - Country:US
Mailing Address - Phone:928-333-3338
Mailing Address - Fax:928-333-3338
Practice Address - Street 1:500 N BECKER LAKE RD
Practice Address - Street 2:
Practice Address - City:SPRINGERVILLE
Practice Address - State:AZ
Practice Address - Zip Code:85938-5020
Practice Address - Country:US
Practice Address - Phone:928-333-3338
Practice Address - Fax:928-333-3338
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ00-592207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine