# WOMEN CLINIC OF NORTHERN ARIZONA

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

## Provider details

- **NPI number:** 1780917369
- **Authorized official:** JAN O SHIELS MD (PHYSICIAN)
- **Authorized official phone:** (928) 779-0341

## Contact information

- **Practice address:** 1024 N SAN FRANCISCO ST STE 105, FLAGSTAFF, AZ 86001-3266
- **Practice address phone:** (928) 779-0341
- **Practice address fax:** (928) 774-4994
- **Mailing address:** 1024 N SAN FRANCISCO ST STE 105, FLAGSTAFF, AZ 86001-3266
- **Mailing address phone:** (928) 779-0341
- **Mailing address fax:** (928) 774-4994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 22985 | AZ | Yes |

## Other

- **Enumeration date:** 09/14/2009
- **Last updated:** 09/14/2009