Organization
NORTHERN ARIZONA MED-PSYCH CLINIC, PLLC
Active
Other names
NAMPC, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA COLLEEN TOLLESON (CO-OWNER)
(928) 821-5173
Entity
Organization
Contact information
Practice address
2155 W SR 89A, ST 105, SEDONA, AZ 86336-5468
(928) 821-3403
(928) 282-1852
Mailing address
989 S MAIN ST, BOX 447, COTTONWOOD, AZ 86326-4601
(928) 821-3403
(928) 282-1852
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
36928
AZ
208D00000X
General Practice Physician
36928
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000092216
BLUE CROSS BLUE SHIELD
MT
01
—
000085117
MEDICARE ID
MT
05
—
231772
—
AZ
01
—
36928
ARIZONA MEDICAL BOARD
AZ
Enumeration date
12/03/2014
Last updated
03/07/2023
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