| Bethany Medical L.l.c | |
| 
					5832 W. San Miguel Ave #6 Glendal AZ 85301  | |
| (623) 939-6224 | |
| (623) 939-6224 | 
| Full Name | Bethany Medical L.l.c | 
|---|---|
| Speciality | Family Medicine | 
| Location | 5832 W. San Miguel Ave #6, Glendal, Arizona | 
| Authorized Official Name and Position | Valentine E Okon (ADMINISTRATOR) | 
| Authorized Official Contact | 6238479800 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Bethany Medical L.l.c 5832 W. San Miguel Ave #6 Glendal AZ 85301 Ph: (623) 939-6224  | Bethany Medical L.l.c 5832 W. San Miguel Ave #6 Glendal AZ 85301 Ph: (623) 939-6224  | 
| NPI Number | 1053433912 | 
|---|---|
| Provider Enumeration Date | 04/04/2007 | 
| Last Update Date | 07/31/2008 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1053433912 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 15873 (Arizona) | Primary |