Homewood Family Medicine Pllc

LBN: Homewood Family Medicine Pllc
Homewood Family Medicine Pllc is an health care organization with primary practice located at 4540 E Baseline Rd #113, Mesa AZ 85206-4613. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Homewood Family Medicine Pllc can be contacted via phone (480) 558-4700, or through Homewood, Russell Jay via phone (480) 558-4700.

Contact Information

Primary practice address
4540 E Baseline Rd #113 Mesa AZ 85206-4613
Fax: (480) 558-1936
Website:
Authorized official contact:
Name: Homewood, Russell Jay Doctor of Osteopathy (DO)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3268 Arizona

Profile Details

NPI number 1144206541
LBN Legal business name Homewood Family Medicine Pllc
DBA Doing business as
Authorized official Homewood, Russell Jay Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 16th, 2005
Last updated Oct 18th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144206541 NPPES
Arizona MEDICAID 423997

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