Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lone Wolf Medicine, Inc

Organization Medical Physician Assistant · NPI 1053504225

Lone Wolf Medicine, Inc is a Medical Physician Assistant in Payson, Arizona. Licensed in Arizona. Registered with an NPI since 2007.

Licensed in
AZ
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

806 S Ponderosa St
Payson, AZ 85541-5541
Phone: (928) 474-6617
Fax: (928) 474-7059
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 1454 (AZ)

Record details

NPI number1053504225
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marilyn Heron — Physician Assisitant · (928) 474-6617
NPI enumeratedAugust 21, 2007
Last updated in NPPESAugust 21, 2007
Mailing addressPo Box 1670, Payson, AZ 85547-1670