Organization
JR MEDICAL GROUP, PLC
Active
Other names
Cornerstone Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
KENDRA THOMPSON (DIRECTOR)
(480) 981-6100
Entity
Organization
Contact information
Practice address
4545 E SOUTHERN AVE STE 103, MESA, AZ 85206-2677
(480) 981-6100
(480) 981-5501
Mailing address
4545 E SOUTHERN AVE, SUITE 103, MESA, AZ 85206
(480) 981-6100
(480) 981-5501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080179242
RAILROAD MEDICARE PROVIDER #
AZ
01
—
080181881
RAILROAD MEDICARE PROVIDER ID #
AZ
05
—
411863
—
AZ
05
—
482323
—
AZ
05
—
489254
—
AZ
Enumeration date
04/03/2007
Last updated
05/21/2024
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