Organization
MACHUZAK DERMATOLOGY PLLC
Active
Other names
JM Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA MORELAND (PRACTICE MANAGER)
(480) 621-2070
Entity
Organization
Contact information
Practice address
3198 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314-2239
(928) 202-4143
(928) 233-8917
Mailing address
3198 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314-2239
(928) 202-4143
(928) 233-8917
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
453107
—
AZ
Enumeration date
02/16/2019
Last updated
05/23/2019
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