| Grayhawk Family Practice | |
|
10051 E Dynamite Blvd Ste 110 Scottsdale AZ 85262-5239 | |
| (480) 473-7003 | |
| (480) 473-4499 |
| Full Name | Grayhawk Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 10051 E Dynamite Blvd Ste 110, Scottsdale, Arizona |
| Authorized Official Name and Position | Arnetta Blackwell (CEO) |
| Authorized Official Contact | 4804737003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grayhawk Family Practice 10051 E Dynamite Blvd Ste 110 Scottsdale AZ 85262-5239 Ph: (480) 473-7003 | Grayhawk Family Practice 10051 E Dynamite Blvd Ste 110 Scottsdale AZ 85262-5239 Ph: (480) 473-7003 |
| NPI Number | 1013491166 |
|---|---|
| Provider Enumeration Date | 09/24/2018 |
| Last Update Date | 05/22/2023 |
| Certification Date | 05/22/2023 |
| Medicare PECOS PAC ID | 3577806314 |
|---|---|
| Medicare Enrollment ID | O20190520001788 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013491166 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Ida Crocker Sabbagh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396808432 PECOS PAC ID: 7113829102 Enrollment ID: I20040121000731 |
| Provider Name | Linda L Motsch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689630402 PECOS PAC ID: 5799753588 Enrollment ID: I20040920000818 |
| Provider Name | Wendy Song |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144660671 PECOS PAC ID: 5597050211 Enrollment ID: I20160819001543 |
| Provider Name | Stephanie a Bragg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083764229 PECOS PAC ID: 8729584560 Enrollment ID: I20251001001514 |
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