Mountain Pediatrics Clinic Pllc

LBN: Mountain Pediatrics Clinic Pllc
Mountain Pediatrics Clinic Pllc is an health care organization with primary practice located at 5171 Cub Lake Road Suite B230, Show Low AZ 85901-7888. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Mountain Pediatrics Clinic Pllc can be contacted via phone (928) 537-3500, or through Todhunter, Richard via phone (928) 537-3500.

Contact Information

Primary practice address
5171 Cub Lake Road Suite B230 Show Low AZ 85901-7888
Phone: (928) 537-3500
Fax: (928) 537-3552
Website:
Map and Directions
Authorized official contact:
Name: Todhunter, Richard Doctor of Medicine (MD)
Phone: (928) 537-3500

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 31953 Arizona

Profile Details

NPI number 1033273735
LBN Legal business name Mountain Pediatrics Clinic Pllc
DBA Doing business as
Authorized official Todhunter, Richard Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 20th, 2006
Last updated Aug 22nd, 2020 - about 5 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 1033273735 NPPES
Arizona MEDICAID 799942

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