| Fortuna Medical Group | |
|
11510 S Fortuna Rd Suite A Yuma AZ 85367-7843 | |
| (928) 342-7046 | |
| (928) 342-7018 |
| Full Name | Fortuna Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 11510 S Fortuna Rd, Yuma, Arizona |
| Authorized Official Name and Position | Oswald Lopez (MANAGER) |
| Authorized Official Contact | 9283427046 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fortuna Medical Group 11510 S Fortuna Rd Ste A Yuma AZ 85367-7843 Ph: (928) 342-7046 | Fortuna Medical Group 11510 S Fortuna Rd Suite A Yuma AZ 85367-7843 Ph: (928) 342-7046 |
| NPI Number | 1386044477 |
|---|---|
| Provider Enumeration Date | 08/26/2014 |
| Last Update Date | 09/28/2023 |
| Medicare PECOS PAC ID | 2264721968 |
|---|---|
| Medicare Enrollment ID | O20160519001610 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386044477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Lloyd D Wagner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124161872 PECOS PAC ID: 3870517923 Enrollment ID: I20160613001808 |
| Provider Name | Steven M Kuder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417290594 PECOS PAC ID: 8224322201 Enrollment ID: I20160815000958 |
| Provider Name | Tod P Work |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871030825 PECOS PAC ID: 1153674742 Enrollment ID: I20181031000772 |
| Provider Name | Karen B Barcklay |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1881825164 PECOS PAC ID: 6901147883 Enrollment ID: I20190402001232 |
| Provider Name | Kristine Therese Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821735424 PECOS PAC ID: 7810373826 Enrollment ID: I20220928002609 |
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