Organization
OCOTILLO FAMILY MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GIL HOLLAND MD (OWNER)
(480) 706-0174
Entity
Organization
Contact information
Practice address
16515 S 40TH ST, SUITE 109, PHOENIX, AZ 85048-0558
(480) 706-0174
Mailing address
16515 S 40TH ST, SUITE 109, PHOENIX, AZ 85048-0558
(480) 706-0174
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31233
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
522104
—
AZ
05
—
776130
—
AZ
Enumeration date
04/14/2006
Last updated
10/02/2015
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