Organization
PUEBLO FAMILY PHYSICIANS LTD
Active
Parent organization
PUEBLO FAMILY PHYSICIANS LTD
Other names
Pueblo Family Physicians LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
PUEBLO FAMILY PHYSICIANS LTD
Authorized official
RICK JOHNS (PRACTICE ADMINISTRATOR)
(602) 850-8913
Entity
Organization
Contact information
Practice address
4350 N 19TH AVE, SUITE 6, PHOENIX, AZ 85015-4602
(602) 264-9191
(602) 532-2973
Mailing address
4350 N 19TH AVE STE 6, PHOENIX, AZ 85015-4602
(602) 850-8913
(602) 532-2956
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2325
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423779
—
AZ
Enumeration date
08/15/2006
Last updated
02/09/2024
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