Organization
PALO VERDE FAMILY MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL L MONTGOMERY (MEMBER)
(623) 878-5800
Entity
Organization
Contact information
Practice address
7615 W THUNDERBIRD RD, STE 106, PEORIA, AZ 85381-6083
(623) 878-5800
(623) 878-5807
Mailing address
PO BOX 4196, BELFAST, ME 04915-4100
(623) 878-5800
(623) 878-5807
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
696933
—
AZ
Enumeration date
03/16/2012
Last updated
11/05/2012
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