# ORACLE HEALTHCARE

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

## Provider details

- **NPI number:** 1396900122
- **Authorized official:** HEATHER PETERSEN (ADMINISTRATOR)
- **Authorized official phone:** (928) 649-6477

## Contact information

- **Practice address:** 348 S MAIN ST, STE 1, CAMP VERDE, AZ 86322-7155
- **Practice address phone:** (928) 649-6477
- **Practice address fax:** (928) 649-2719
- **Mailing address:** PO BOX 1270, CLARKDALE, AZ 86324-1270
- **Mailing address phone:** (928) 649-6477
- **Mailing address fax:** (928) 649-2719

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2008
- **Last updated:** 11/19/2010