Southwest I.d. & Medical Clinic, Lc
Southwest I.d. & Medical Clinic, Lc is an Infectious Disease Physician in Prescott Valley, Arizona. Licensed in Arizona. Registered with an NPI since 2006.
- Licensed in
- AZ
- In the registry since
- 2006
Practice location Address checks out
3235 N Windsong DrPrescott Valley, AZ 86314-1222
Phone: (928) 772-3340
Fax: (928) 759-9611
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Specialties & licences
| Infectious Disease Physician (primary) | Taxonomy 207RI0200X · Licence 29064 (AZ) |
|---|
Record details
| NPI number | 1275563975 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Alpana Jetly — Manager · (928) 772-3340 |
| NPI enumerated | July 5, 2006 |
| Last updated in NPPES | September 7, 2023 |
| Certification date | September 7, 2023 |
| Mailing address | Po Box 1629, Prescott, AZ 86302-1629 |
Other providers in Prescott Valley
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Dr. Rajiv Jetly, MD
3235 N Windsong Dr, Prescott Valley, AZ 86314-1222 · (928) 772-3340