Organization
PRESCOTT CARDIOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS WAYNE ROTHROCK M.D. (OWNER/PROVIDER)
(928) 776-0601
Entity
Organization
Contact information
Practice address
804 AINSWORTH DR, SUITE 102, PRESCOTT, AZ 86301-1624
(928) 776-0601
(928) 776-0620
Mailing address
804 AINSWORTH DR, SUITE 102, PRESCOTT, AZ 86301-1624
(928) 776-0601
(928) 776-0620
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
26235
AZ
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
438780
—
AZ
Enumeration date
05/16/2006
Last updated
11/17/2016
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