Provider Provider PC

General Practice Physician · Mesa, AZ

Organization Active NPI

NPI number 1760969190

Practice location

841 W 11TH St
Mesa, AZ 85201-3109
Phone
(480) 461-9822

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NPI record

NPI
1760969190
Entity type
Organization (Type 2)
Enumeration date
July 28, 2018
Last updated
December 20, 2018
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Physician Primary 208D00000X — —

Authorized official

Name
Jonathan Harris, PHYSICIAN ASSISTANT
Title
PA-C/Member of Corporation
Phone
(480) 461-9822

About Provider Provider PC

Provider Provider PC is a healthcare organization registered in the NPI registry with the primary taxonomy General Practice Physician (code 208D00000X). The practice location is 841 W 11TH St, Mesa, AZ 85201-3109. The NPI number 1760969190 was assigned on July 28, 2018 and the record was last updated on December 20, 2018.

The authorized official for this organization is Jonathan Harris, PHYSICIAN ASSISTANT, PA-C/Member of Corporation.

Frequently asked questions

What is the NPI number of Provider Provider PC?

The NPI number is 1760969190.

What is the phone number of Provider Provider PC?

The phone number listed for the practice location is (480) 461-9822.

Where is Provider Provider PC located?

841 W 11TH St, Mesa, AZ 85201-3109.

What is the taxonomy code for Provider Provider PC?

The primary taxonomy code is 208D00000X – General Practice Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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