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Organization
PRINCIPAL-NEEDLES INC
Active
Organization
PRINCIPAL-NEEDLES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM M GRACEY (CHIEF OPERATING OFFICER)
(615) 372-8500
Entity
Organization
Contact information
Practice address
1401 BAILEY AVE, NEEDLES, CA 92363-3103
(760) 326-4531
Mailing address
103 POWELL CT, SUITE 200, BRENTWOOD, TN 37027-5079
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
01/12/2007
Last updated
09/09/2008
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