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Organization
DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
Active
Organization
DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
Active
Other names
Phoenix Indian Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LAURA A TILLMAN MD (CMO)
(602) 581-6080
Entity
Organization
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 200-5383
Mailing address
PO BOX 95460, CLEVELAND, OH 44101-0033
(602) 581-6088
(602) 263-1619
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
NULL
Other
Enumeration date
07/02/2006
Last updated
03/19/2024
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