# FAMILY PRACTICE CLINIC LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245423789
- **Authorized official:** DR. CHARLES E MYERS DO (PRESIDENT)
- **Authorized official phone:** (602) 278-4930

## Contact information

- **Practice address:** 3306 W ROOSEVELT ST, STE A, PHOENIX, AZ 85009-3404
- **Practice address phone:** (602) 278-4930
- **Mailing address:** 3306 W ROOSEVELT ST, STE A, PHOENIX, AZ 85009-3404
- **Mailing address phone:** (602) 278-4930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 1239 | AZ | Yes |

## Other

- **Enumeration date:** 08/18/2007
- **Last updated:** 09/28/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 261131 | — | AZ |