| Keystone Medical, Pllc | |
|
77 Calle Portal Suite B260a Sierra Vista AZ 85635-2967 | |
| (520) 226-4338 | |
| (520) 515-9786 |
| Full Name | Keystone Medical, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 77 Calle Portal, Sierra Vista, Arizona |
| Authorized Official Name and Position | Rebecca Pradhan-nara (SOLE MEMBER) |
| Authorized Official Contact | 5202664338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keystone Medical, Pllc 77 Calle Portal Suite B260a Sierra Vista AZ 85635-2967 Ph: (520) 226-4338 | Keystone Medical, Pllc 77 Calle Portal Suite B260a Sierra Vista AZ 85635-2967 Ph: (520) 226-4338 |
| NPI Number | 1477975647 |
|---|---|
| Provider Enumeration Date | 01/07/2014 |
| Last Update Date | 01/20/2016 |
| Medicare PECOS PAC ID | 9739312075 |
|---|---|
| Medicare Enrollment ID | O20140512001434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477975647 | NPI | - | NPPES |
| 897280 | Medicaid | AZ |
| Provider Name | Rebecca Pradhan Nara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083602700 PECOS PAC ID: 2365438330 Enrollment ID: I20040423000951 |
| Provider Name | Laura L Elliott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093955023 PECOS PAC ID: 5991994253 Enrollment ID: I20110118001098 |
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