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Organization

STARFIGHTER, LLC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONALD WAYNE RUNYAN DO (OWNER)
(928) 726-4234
Entity
Organization

Contact information

Practice address
1501 W 24TH ST, YUMA, AZ 85364-6370
(928) 344-2000
Mailing address
PO BOX 1070, YUMA, AZ 85366-1070
(928) 726-4234
(928) 726-4241

Taxonomy

Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
3599
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
XPY195112
AZ
Enumeration date
07/30/2007
Last updated
07/31/2007
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