Individual
MRS. LORI A CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1619
Mailing address
PO BOX 95460, CLEVELAND, OH 44101-0033
(602) 263-1200
(602) 263-1619
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD196778
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500775586
—
OR
Enumeration date
06/30/2006
Last updated
01/28/2024
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