Organization
BMI423I
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THUY NGUYEN (MANAGER)
(602) 492-8606
Entity
Organization
Contact information
Practice address
412 WHIPPLE ST, PRESCOTT, AZ 86301-1712
(480) 788-5621
(480) 779-1277
Mailing address
412 WHIPPLE ST, PRESCOTT, AZ 86301-1712
(480) 788-5621
(480) 779-1277
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
11/24/2025
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