institution
Lone Wolf Medicine, Inc
Medical Physician Assistant in Payson, Arizona
NPI 1053504225

Lone Wolf Medicine, Inc is a Medical Physician Assistant based in Payson, AZ and is specialized in Medical. Lone Wolf Medicine, Inc practices in Payson, AZ. The NPI Number for Lone Wolf Medicine, Inc is 1053504225 and holds a License No. 1454 (Arizona).

The current practice location address for Lone Wolf Medicine, Inc is 806 S Ponderosa St, Payson, AZ and can be reached out via phone at 928-474-6617 and via fax at 928-474-7059.

Location: 806 S Ponderosa St, Payson, AZ, 85547-1670
institution
Provider Profile Details
NPI Number
1053504225
Provider Name
Lone Wolf Medicine, Inc
Credential
Provider Entity Type
Organization
Address
806 S Ponderosa St, Payson, AZ, 85547-1670
Phone Number
928-474-6617
Fax Number
928-474-7059
Provider Enumeration Date
08/21/2007
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
2Z0986 01 AZ HEALTHNET
137861 05 AZ
institution
Provider Business Practice Location Address Details
Address
806 S Ponderosa St
City
State
Zip
85541-5541
Phone Number
928-474-6617
Fax Number
928-474-7059
person
Provider Business Mailing Address Details
Address
806 S Ponderosa St
City
State
Zip
85541-5541
Phone Number
928-474-6617
Fax Number
928-474-7059
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
1454 (Arizona)
Definition
Definition to come...
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