# STATE OF ARIZONA DEPARTMENT OF CORRECTIONS

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

## Provider details

- **NPI number:** 1255566477
- **Authorized official:** LINDSEY R CHITWOOD MASTERS (PHYSICIAN ASSISTANT)
- **Authorized official phone:** (520) 868-4011

## Contact information

- **Practice address:** 1305 E BUTTE AVE, FLORENCE, AZ 85232
- **Practice address phone:** (520) 868-4011
- **Practice address fax:** (602) 258-7886
- **Mailing address:** 3846 E PALMER ST, GILBERT, AZ 85298-8855

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2400X | Prison Health Clinic/Center | 3816 | AZ | Yes |

## Other

- **Enumeration date:** 05/18/2009
- **Last updated:** 05/18/2009