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Organization
MKRP INDUSTRIES INCORPORATION
Active
Organization
MKRP INDUSTRIES INCORPORATION
Active
Other names
CANYON FAMILY PHYSICIANS
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS PICKERING (OWNER)
(602) 889-7550
Entity
Organization
Contact information
Practice address
2451 E BASELINE RD, SUITE 130, GILBERT, AZ 85234-2471
(480) 507-2213
(480) 507-0677
Mailing address
2451 E BASELINE RD, SUITE 130, GILBERT, AZ 85234-2471
(480) 507-2213
(480) 507-0677
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
33546
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2Z2444
HEALTH NET
AZ
05
—
916562
—
AZ
Enumeration date
09/20/2005
Last updated
08/11/2008
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