Individual
DR. SHARON LYNN DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 214-2920
(928) 214-2925
Mailing address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 773-2559
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4220
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
963349
—
AZ
01
—
AZ0785540
BCBS
—
01
—
P03195393
RAILROAD MEDICARE
AZ
Enumeration date
09/22/2006
Last updated
03/14/2017
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