Organization
BEATRICE KELLER CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES W GROFF D.O. (PRESIDENT)
(623) 584-2127
Entity
Organization
Contact information
Practice address
13943 N 91ST AVE, C-101, PEORIA, AZ 85381-3687
(623) 972-3992
(623) 974-9351
Mailing address
13943 N 91ST AVE, C-101, PEORIA, AZ 85381-3687
(623) 972-3992
(623) 974-9351
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000838542
EVERCARE
AZ
01
—
0813027
AETNA
AZ
01
—
0846027
AETNA
AZ
01
—
1467402933
AHCCCS
AZ
01
—
188961600
DEPT OF LABOR WORK COMP
AZ
01
—
4265098
CIGNA
AZ
01
—
838542
UNITED HEALTH CARE
AZ
01
—
CT0844
RAILROAD MEDICARE
AZ
Enumeration date
05/12/2006
Last updated
06/11/2008
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