| 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 |