| Copper Queen Medical Associates Douglas | |
|
100 E 5th St Douglas AZ 85607-2859 | |
| (520) 364-7659 | |
| (520) 364-8541 |
| Full Name | Copper Queen Medical Associates Douglas |
|---|---|
| Speciality | Clinic/center |
| Location | 100 E 5th St, Douglas, Arizona |
| Authorized Official Name and Position | Betty Jo Carrizoza (OFFICE MANAGER) |
| Authorized Official Contact | 5203647659 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Copper Queen Medical Associates Douglas 100 E 5th St Douglas AZ 85607-2859 Ph: (520) 364-7659 | Copper Queen Medical Associates Douglas 100 E 5th St Douglas AZ 85607-2859 Ph: (520) 364-7659 |
| NPI Number | 1942217088 |
|---|---|
| Provider Enumeration Date | 08/02/2006 |
| Last Update Date | 08/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942217088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | OTC-3364 (Arizona) | Primary |
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