# NORTHERN APACHE COUNTY SPECIAL HEALTH CARE DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St. Michaels Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679757819
- **Authorized official:** MRS. DAWN MARTINEZ (BUSINESS OFFICE MANAGER)
- **Authorized official phone:** (928) 810-3814

## Contact information

- **Practice address:** 359 WEST HIGHWAY 264, SUITE A, SAINT MICHAELS, AZ 86511
- **Practice address phone:** (928) 810-3800
- **Practice address fax:** (928) 810-3801
- **Mailing address:** PO BOX 370, SAINT MICHAELS, AZ 86511-0370
- **Mailing address phone:** (928) 810-3814
- **Mailing address fax:** (928) 810-3811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OTC2967 | AZ | Yes |

## Other

- **Enumeration date:** 12/24/2007
- **Last updated:** 12/24/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 68357303 | — | NM |
| 05 | — | 709248 | — | AZ |