| Gilbert Physical Medicine LLC | |
|
725 W Elliot Rd Suite 115 Gilbert AZ 85233-5301 | |
| (480) 545-0000 | |
| (480) 545-7615 |
| Full Name | Gilbert Physical Medicine LLC |
|---|---|
| Speciality | General Practice |
| Location | 725 W Elliot Rd, Gilbert, Arizona |
| Authorized Official Name and Position | Alisa Wasserman (OWNER/OPERATOR) |
| Authorized Official Contact | 4805450000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gilbert Physical Medicine LLC 725 W Elliot Rd Suite 115 Gilbert AZ 85233-5301 Ph: (480) 545-0000 | Gilbert Physical Medicine LLC 725 W Elliot Rd Suite 115 Gilbert AZ 85233-5301 Ph: (480) 545-0000 |
| NPI Number | 1265708317 |
|---|---|
| Provider Enumeration Date | 03/22/2012 |
| Last Update Date | 03/22/2012 |
| Medicare PECOS PAC ID | 2466697982 |
|---|---|
| Medicare Enrollment ID | O20130403000425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265708317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | David C Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023088531 PECOS PAC ID: 7012991011 Enrollment ID: I20040616001348 |
| Provider Name | Jillian F Jackson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336246628 PECOS PAC ID: 1153373220 Enrollment ID: I20050216000949 |
| Provider Name | Clinton L Huston |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1235171844 PECOS PAC ID: 9234170333 Enrollment ID: I20050519000095 |
| Provider Name | Alisa M Wasserman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1124061916 PECOS PAC ID: 4284669292 Enrollment ID: I20050928001052 |
| Provider Name | Janet E Orozco |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1285745091 PECOS PAC ID: 2961408406 Enrollment ID: I20061006000112 |
| Provider Name | Bradley Christopher Doan |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1598904096 PECOS PAC ID: 7012056013 Enrollment ID: I20091204000279 |
| Provider Name | Jennifer K Stern |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053647909 PECOS PAC ID: 3072642149 Enrollment ID: I20100527000694 |
| Provider Name | Ann Cheri Foxx |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1639110455 PECOS PAC ID: 5395716435 Enrollment ID: I20110922000691 |
| Provider Name | Thomas A. Morgan |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1578538898 PECOS PAC ID: 6901866763 Enrollment ID: I20120703000475 |
| Provider Name | Laura Marie Paulson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972053072 PECOS PAC ID: 2365724069 Enrollment ID: I20170112001240 |
| Provider Name | Ambrosia M Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336647692 PECOS PAC ID: 8426312158 Enrollment ID: I20180504002192 |
| Provider Name | Katherine L Gaitan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609327741 PECOS PAC ID: 6305126798 Enrollment ID: I20190625001258 |
| Provider Name | Christy Lacey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942881271 PECOS PAC ID: 5496164741 Enrollment ID: I20210517002470 |
| Provider Name | Shannon Grace Chittenden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356947550 PECOS PAC ID: 5890184790 Enrollment ID: I20211116000011 |
| Provider Name | Bryce Bisching |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548658974 PECOS PAC ID: 6608190251 Enrollment ID: I20221004000920 |
| Provider Name | Michael Doiron |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942264320 PECOS PAC ID: 6608035126 Enrollment ID: I20230126003262 |
| Provider Name | Curtis Casady |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1972588218 PECOS PAC ID: 2264597244 Enrollment ID: I20230227002640 |
| Provider Name | Albert Dean Stuart |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1700929379 PECOS PAC ID: 4486688660 Enrollment ID: I20240730000385 |
| Provider Name | Suzan Al-saleh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033944038 PECOS PAC ID: 6800337825 Enrollment ID: I20240918001253 |
| Provider Name | Lindsey Virgadaula |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821724279 PECOS PAC ID: 4688050206 Enrollment ID: I20241001004031 |
| Provider Name | Paul R Sawala |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1649846965 PECOS PAC ID: 5597154427 Enrollment ID: I20260622003398 |
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