# PALO VERDE FAMILY MEDICINE PLLC

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

## Provider details

- **NPI number:** 1417222969
- **Authorized official:** DARRYL L MONTGOMERY (MEMBER)
- **Authorized official phone:** (623) 878-5800

## Contact information

- **Practice address:** 7615 W THUNDERBIRD RD, STE 106, PEORIA, AZ 85381-6083
- **Practice address phone:** (623) 878-5800
- **Practice address fax:** (623) 878-5807
- **Mailing address:** PO BOX 4196, BELFAST, ME 04915-4100
- **Mailing address phone:** (623) 878-5800
- **Mailing address fax:** (623) 878-5807

## Taxonomy

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

## Other

- **Enumeration date:** 03/16/2012
- **Last updated:** 11/05/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 696933 | — | AZ |