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

Provider Provider PC

Organization General Practice Physician · NPI 1760969190

Provider Provider PC is a General Practice Physician in Mesa, Arizona. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

841 W 11th St
Mesa, AZ 85201-3109
Phone: (480) 461-9822
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1760969190
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jonathan Harris — Pa-C/Member Of Corporation · (480) 461-9822
NPI enumeratedJuly 28, 2018
Last updated in NPPESDecember 20, 2018
Mailing address841 W 11th St, Mesa, AZ 85201-3109

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