Organization
COMMUNITY HEALTH CARE OF DOUGLAS
Active
Other names
Southeast Arizona Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN BICKELL (CEO)
(520) 805-5940
Entity
Organization
Contact information
Practice address
2174 W OAK AVE, DOUGLAS, AZ 85607
(520) 805-5813
Mailing address
2174 W OAK AVE, DOUGLAS, AZ 85607-6003
(520) 805-5813
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55843901
—
AZ
Enumeration date
11/24/2009
Last updated
11/24/2009
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