Organization
GERALD P. FORD, M.D. P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD PENNY FORD M.D. (PRESIDENT)
(480) 967-3381
Entity
Organization
Contact information
Practice address
2600 S RURAL RD STE B, TEMPE, AZ 85282-2448
(480) 967-3381
(480) 967-0755
Mailing address
2600 S RURAL RD STE B, TEMPE, AZ 85282-2448
(480) 967-3381
(480) 967-0755
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
7813
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180005504
RAILROAD MEDICARE
AZ
05
—
246703
—
AZ
01
—
4022003
AETNA
AZ
01
—
AZ0017680
BLUECROSS BLUE SHIELD
AZ
Enumeration date
01/03/2008
Last updated
09/07/2018
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