Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2007-03-20
- Last updated
- 2008-05-21
Licenses
- License AZ
- 2782
Location
- Practice location
- 3303 E BASELINE RD, SUITE 203
- City
- GILBERT AZ
- Postal code
- 852342738
- Phone
- 480-968-7600
Organization contact
- Name
- MICHAEL BARRY
- Title
- PHYSICIAN MANAGER
- Phone
- 4809687600
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.