| George Roso, M.D., P.l.l.c | |
|
255 S Dobson Rd Ste 1 Chandler AZ 85224-6231 | |
| (480) 722-2595 | |
| Not Available |
| Full Name | George Roso, M.D., P.l.l.c |
|---|---|
| Speciality | Family Medicine |
| Location | 255 S Dobson Rd Ste 1, Chandler, Arizona |
| Authorized Official Name and Position | George M. Roso (OWNER) |
| Authorized Official Contact | 4807222595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| George Roso, M.D., P.l.l.c 255 S Dobson Rd Ste 1 Chandler AZ 85224-6231 Ph: (480) 722-2595 | George Roso, M.D., P.l.l.c 255 S Dobson Rd Ste 1 Chandler AZ 85224-6231 Ph: (480) 722-2595 |
| NPI Number | 1265619308 |
|---|---|
| Provider Enumeration Date | 01/30/2008 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 8224112313 |
|---|---|
| Medicare Enrollment ID | O20080228000000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265619308 | NPI | - | NPPES |
| 716209 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 27616 (Arizona) | Primary |
| Provider Name | George M Roso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467425520 PECOS PAC ID: 9032134929 Enrollment ID: I20051010000948 |
| Provider Name | Christine C Lagrow |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902094675 PECOS PAC ID: 4789745571 Enrollment ID: I20081211000764 |
| Provider Name | Camilyn Thorpe |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548631526 PECOS PAC ID: 5092025429 Enrollment ID: I20151113001575 |
| Provider Name | Taylor a Lukas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396114922 PECOS PAC ID: 6709186448 Enrollment ID: I20151201002825 |
| Provider Name | Samantha Rose Labuda |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730649443 PECOS PAC ID: 3476895491 Enrollment ID: I20190423001655 |
| Provider Name | Corina Christine Cunningham |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205205010 PECOS PAC ID: 6901199298 Enrollment ID: I20190527000007 |
| Provider Name | Dominic Michael Farrell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326656844 PECOS PAC ID: 2264844166 Enrollment ID: I20201217002743 |
| Provider Name | Elizabeth a Marino |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457933673 PECOS PAC ID: 5395154397 Enrollment ID: I20210504000631 |
| Provider Name | Alexa Graham |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386323491 PECOS PAC ID: 8325409790 Enrollment ID: I20230801003596 |
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