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Specialty details in registry · Prescott Valley, AZ

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At a glance

7760 E State Route 69, Prescott Valley, AZ 86314-2201

NPPES record updated Apr 24, 2017. Public records can lag behind changes at a practice.

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  • Are you accepting new patients?
  • Do you accept my specific insurance plan?
  • Do you provide the service I need at this address?
  • Do I need a referral, and what is the earliest appointment?

Insurance participation and appointment availability are not established by these public records.

Practice location

7760 E State Route 69 C5-207
Prescott Valley, AZ 86314-2201
Professional details: NPI, taxonomy & registry record
NPI1861936908
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
261QS1200X
Enumeration date
Dec 8, 2016
Record updated
Apr 24, 2017
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

261QS1200X · Primary

License reported: 16-00017353 AZ

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

7760 E State Route 69
C5-207
Prescott Valley, AZ 86314-2201
Phone
(928) 899-6686
Fax
(877) 275-2212
Mailing address
7760 E STATE ROUTE 69
C5-207
PRESCOTT VALLEY, AZ 863142201
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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