Organization
FPS MEDICAL CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE PATRICK (PRACTICE MANAGER)
(928) 453-1970
Entity
Organization
Contact information
Practice address
297 LAKE HAVASU AVE S STE 204, LAKE HAVASU CITY, AZ 86403-6526
(928) 453-1970
(928) 855-7229
Mailing address
297 LAKE HAVASU AVE S STE 204, LAKE HAVASU CITY, AZ 86403-6526
(928) 453-1970
(928) 855-7229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CF9336
RAILROAD MEDICARE
AZ
Enumeration date
02/28/2008
Last updated
10/12/2023
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