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Individual

GREGG PHILLIPS STANDAGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1515 S 20TH AVE, SAFFORD, AZ 85546-4009
(928) 348-1370
(928) 348-1375
Mailing address
225 S REAY LN, THATCHER, AZ 85552-5417
(928) 428-0144
(928) 348-1375

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD22289
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
356586
AZ
Enumeration date
07/05/2006
Last updated
09/21/2007
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