Organization
PRESCOTT GASTROENTEROLOGY
Active
Other names
Prescott Gastroenterology Consultants Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBIE MARIE DE LUNA (OFFICE MANAGER)
(928) 771-5548
Entity
Organization
Contact information
Practice address
811 AINSWORTH DR STE 103, PRESCOTT, AZ 86301-1687
(928) 771-5548
(928) 771-5549
Mailing address
811 AINSWORTH DR STE 103, PRESCOTT, AZ 86301-1687
(928) 771-5548
(928) 771-5549
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
22747
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176950
—
AZ
Enumeration date
03/12/2007
Last updated
08/27/2010
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