Organization · Type 2 NPI
Lone Wolf Medicine, Inc
Medical Physician Assistant · Payson, AZ
NPI number
1053504225
Active
Practice location
806 S Ponderosa St
Payson, AZ 85541-5541
Fax (928) 474-7059
Mailing address
PO Box 1670
Payson, AZ 85547-1670
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 1454 (AZ) |
Medical Physician Assistant: Definition to come...
5 other providers at this address
- Ponderosa Family Care, LLCInternal Medicine Physician Payson, AZ NPI 1144535626
- Durward Lynch, CNPNurse Practitioner Payson, AZ NPI 1699747915
- Lauren Washatka, MDInternal Medicine Physician Payson, AZ NPI 1821651746
- Lynne A. Vigil, N.P.Nurse Practitioner Payson, AZ NPI 1912967704
- Michael Keene Demack, PA C SMedical Physician Assistant Payson, AZ NPI 1043347313
About NPI 1053504225
Lone Wolf Medicine, Inc's National Provider Identifier is 1053504225, issued on Aug 21, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Payson, AZ. The record was last updated on Aug 21, 2007.