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Organization

PRESCOTT LUNG PHYSICIANS LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CLIFFORD RAUSCHER MD (PRESIDENT/OWNER)
(480) 985-1093
Entity
Organization

Contact information

Practice address
808 AINSWORTH DR, SUITE 103, PRESCOTT, AZ 86301-1625
(480) 985-1093
Mailing address
808 AINSWORTH DR, SUITE 103, PRESCOTT, AZ 86301-1625
(480) 985-1093

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
207RP1001X
Pulmonary Disease Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
290012799
RAIL ROAD MEDICARE
AZ
01
AZ0005360
BCBS
AZ
Enumeration date
10/10/2006
Last updated
06/25/2012
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