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Organization
ANTHONY M DOMINIC SR DO PC
Active
Organization
ANTHONY M DOMINIC SR DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY M DOMINIC SR. DO (PRESIDENT)
(480) 982-1265
Entity
Organization
Contact information
Practice address
850 S IRONWOOD DR, STE 104, APACHE JUNCTION, AZ 85220-6242
(480) 982-1265
(480) 982-8831
Mailing address
850 S IRONWOOD DR, STE 104, APACHE JUNCTION, AZ 85220-6242
(480) 982-1265
(480) 982-8831
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1833
AZ
207Q00000X
Family Medicine Physician
34002451
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160127
—
AZ
01
—
1Z0948
HEALTHNET
AZ
01
—
AZ0390340
BCBS
AZ
Enumeration date
07/12/2005
Last updated
01/14/2008
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