Organization
SIERRA VISTA REGIONAL HEALTH CENTER MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE LAWRENCE (SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
5750 E HIGHWAY 90, SUITE 200, SIERRA VISTA, AZ 85635
(520) 263-3979
(520) 263-3977
Mailing address
5750 E HIGHWAY 90, SUITE 200, SIERRA VISTA, AZ 85635-9111
(520) 263-3979
(520) 263-3977
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
724470
—
AZ
Enumeration date
07/11/2012
Last updated
09/26/2024
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