Organization
YAVAPAI PATHOLOGY ASSOCIATES PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROEL A GALLO MD (PRESIDENT)
(480) 985-1093
Entity
Organization
Contact information
Practice address
1003 WILLOW CREEK RD, PRESCOTT, AZ 86301-1641
(480) 985-1093
(480) 985-0468
Mailing address
PO BOX 20490, MESA, AZ 85277-0490
(480) 985-1093
(480) 985-0468
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB2931
RAIL ROAD MEDICARE GROUP
—
Enumeration date
06/16/2006
Last updated
10/02/2007
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