| Gateway Family Medicine | |
|
4365 E Pecos Rd Suite 134 Gilbert AZ 85295-8053 | |
| (480) 840-9155 | |
| (480) 840-9320 |
| Full Name | Gateway Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 4365 E Pecos Rd, Gilbert, Arizona |
| Authorized Official Name and Position | Timothy C Bryan (OWNER MANAGER) |
| Authorized Official Contact | 4808409155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Family Medicine 4365 E Pecos Rd Suite 134 Gilbert AZ 85295-8053 Ph: (480) 840-9155 | Gateway Family Medicine 4365 E Pecos Rd Suite 134 Gilbert AZ 85295-8053 Ph: (480) 840-9155 |
| NPI Number | 1124224126 |
|---|---|
| Provider Enumeration Date | 06/26/2007 |
| Last Update Date | 12/22/2011 |
| Medicare PECOS PAC ID | 0345341863 |
|---|---|
| Medicare Enrollment ID | O20070726000759 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124224126 | NPI | - | NPPES |
| 104591 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35487 (Arizona) | Primary |
| Provider Name | Timothy C Bryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831133743 PECOS PAC ID: 3577532878 Enrollment ID: I20060811000420 |
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