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Organization

STATE OF ARIZONA DEPARTMENT OF CORRECTIONS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LINDSEY R CHITWOOD MASTERS (PHYSICIAN ASSISTANT)
(520) 868-4011
Entity
Organization

Contact information

Practice address
1305 E BUTTE AVE, FLORENCE, AZ 85232
(520) 868-4011
(602) 258-7886
Mailing address
3846 E PALMER ST, GILBERT, AZ 85298-8855

Taxonomy

Speciality
Code
Description
License number
State
261QP2400X
Prison Health Clinic/Center
Primary
3816
AZ

Other

Enumeration date
05/18/2009
Last updated
05/18/2009
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