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Organization

YAVAPAI REGIONAL MEDICAL CENTER PHYSICIAN CARE LLC

Active
Other names
Yavapai Regional Medical Center Physician Care
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LEE LIVIN (CFO)
(928) 771-5691
Entity
Organization

Contact information

Practice address
802 AINSWORTH DR, SUITE A, PRESCOTT, AZ 86301-1623
(928) 445-6025
(928) 778-3026
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(928) 759-5987
(928) 458-2039

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
207RI0011X
Interventional Cardiology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
475065
AHCCCS
AZ
Enumeration date
10/20/2009
Last updated
04/04/2016
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