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Organization
JR MEDICAL GROUP, PLC
Active
Organization
JR MEDICAL GROUP, PLC
Active
Other names
Cornerstone Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
KENDRA THOMPSON (DIRECTOR)
(480) 981-6100
Entity
Organization
Contact information
Practice address
4545 E SOUTHERN AVE STE 103, MESA, AZ 85206-2677
(480) 981-6100
(480) 981-5501
Mailing address
4545 E SOUTHERN AVE, SUITE 103, MESA, AZ 85206
(480) 981-6100
(480) 981-5501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080179242
RAILROAD MEDICARE PROVIDER #
AZ
01
—
080181881
RAILROAD MEDICARE PROVIDER ID #
AZ
05
—
411863
—
AZ
05
—
482323
—
AZ
05
—
489254
—
AZ
Enumeration date
04/03/2007
Last updated
05/21/2024
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