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Organization
SIERRA VISTA REGIONAL HEALTH CENTER MEDICAL GROUP LLC
Active
Organization
SIERRA VISTA REGIONAL HEALTH CENTER MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE LAWRENCE (SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
5750 E HIGHWAY 90, SUITE 200, SIERRA VISTA, AZ 85635
(520) 263-3979
(520) 263-3977
Mailing address
5750 E HIGHWAY 90, SUITE 200, SIERRA VISTA, AZ 85635-9111
(520) 263-3979
(520) 263-3977
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
213E00000X
Podiatrist
—
NULL
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
724470
—
AZ
Enumeration date
07/11/2012
Last updated
09/26/2024
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