Organization
CIRCLE THE CITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM ELLERT MD (CHIEF MEDICAL OFFICER)
(602) 776-0776
Entity
Organization
Contact information
Practice address
3522 N 3RD AVE, PHOENIX, AZ 85013-3903
(602) 776-9000
(602) 776-9001
Mailing address
300 W CLARENDON AVE STE 200, PHOENIX, AZ 85013-3422
(602) 776-0776
(602) 705-0567
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063426
—
AZ
Enumeration date
05/27/2015
Last updated
10/10/2024
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