Organization
SPECTRUM HEALTHCARE GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORINNE BAILEY (CREDENTIALING SPECIALIST)
(928) 634-2236
Entity
Organization
Contact information
Practice address
990 WILLOW CREEK RD, PRESCOTT, AZ 86301-1640
(928) 634-2236
(928) 634-8960
Mailing address
8 E COTTONWOOD ST, COTTONWOOD, AZ 86326-4382
(928) 634-2236
(928) 634-8960
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
08/14/2019
Last updated
03/09/2020
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