Organization
LA PAZ REGIONAL HOSPITAL INC., DBA PARKER PODIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN BROWN (CEO)
(928) 669-7300
Entity
Organization
Contact information
Practice address
1713 S KOFA AVE STE K, PARKER, AZ 85344-6402
(928) 669-3033
(928) 669-4416
Mailing address
1200 W MOHAVE RD, PARKER, AZ 85344-6349
(928) 669-9201
(928) 669-7409
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
H0138
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031317
MEDICARE OSCAR
AZ
05
—
480046
—
AZ
Enumeration date
06/05/2014
Last updated
02/27/2019
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