Organization
PORVAZNIK FAMILY MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY PORVAZNIK MD (OWNER)
(301) 801-2577
Entity
Organization
Contact information
Practice address
5200 E CORTLAND BLVD STE D3, FLAGSTAFF, AZ 86004-9340
(928) 440-5929
Mailing address
5200 E CORTLAND BLVD STE D3, FLAGSTAFF, AZ 86004-9340
(928) 440-5929
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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