institution
Gerald J Taitague Md Pc
Primary Care Clinic/Center in Williams, Arizona
NPI 1689813834

Gerald J Taitague Md Pc is a Primary Care Clinic/Center based in Williams, AZ and is specialized in Primary Care. Gerald J Taitague Md Pc practices in Williams, AZ. The NPI Number for Gerald J Taitague Md Pc is 1689813834 and holds a License No. 26182 (Arizona).

The current practice location address for Gerald J Taitague Md Pc is 117 W Route 66, Williams, AZ and can be reached out via phone at 928-635-1044 and via fax at 928-635-1042.

Location: 117 W Route 66, Williams, AZ, 86046-2567
institution
Provider Profile Details
NPI Number
1689813834
Provider Name
Gerald J Taitague Md Pc
Credential
Provider Entity Type
Organization
Address
117 W Route 66, Williams, AZ, 86046-2567
Phone Number
928-635-1044
Fax Number
928-635-1042
Provider Enumeration Date
02/11/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
426503 01 AZ AHCCCS
01-0064151 01 AZ RAILROAD MEDICARE
AZ0865880 01 AZ BLUE CROSS
institution
Provider Business Practice Location Address Details
Address
117 W Route 66
City
State
Zip
86046-2567
Phone Number
928-635-1044
Fax Number
928-635-1042
person
Provider Business Mailing Address Details
Address
117 W Route 66
City
State
Zip
86046-2567
Phone Number
928-635-1044
Fax Number
928-635-1042
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
License No.
26182 (Arizona)
Definition
Definition to come...
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