| Lake Havasu Primary Care Pllc | |
|
1830 Mesquite Ave Suite B Lake Havasu City AZ 86403-5885 | |
| (928) 453-0777 | |
| (928) 453-0778 |
| Full Name | Lake Havasu Primary Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1830 Mesquite Ave, Lake Havasu City, Arizona |
| Authorized Official Name and Position | Essa J Sidiqi (OWNER/MEMBER/MANAGER) |
| Authorized Official Contact | 9284530777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Havasu Primary Care Pllc 1830 Mesquite Ave Suite B Lake Havasu City AZ 86403-5885 Ph: (928) 453-0777 | Lake Havasu Primary Care Pllc 1830 Mesquite Ave Suite B Lake Havasu City AZ 86403-5885 Ph: (928) 453-0777 |
| NPI Number | 1194116186 |
|---|---|
| Provider Enumeration Date | 02/11/2015 |
| Last Update Date | 02/11/2015 |
| Medicare PECOS PAC ID | 2567781271 |
|---|---|
| Medicare Enrollment ID | O20150430002184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194116186 | NPI | - | NPPES |
| P-1982371-1 | Other | AZ | PLLC REGISTRATION NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 48667 (Arizona) | Primary |
| Provider Name | Judy G Bandy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922022086 PECOS PAC ID: 6608903828 Enrollment ID: I20100429001263 |
| Provider Name | Essa J Sidiqi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891008934 PECOS PAC ID: 2264667674 Enrollment ID: I20140424001816 |
| Provider Name | Ibrahim H Sidiqi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1649470071 PECOS PAC ID: 8022200112 Enrollment ID: I20150921002666 |
| Provider Name | Sarah Joan Grohmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437511896 PECOS PAC ID: 7618135062 Enrollment ID: I20160531001953 |
| Provider Name | Cheryl A Goodrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932138310 PECOS PAC ID: 0547235152 Enrollment ID: I20170120002585 |
| Provider Name | Suzanne L Hawkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043334832 PECOS PAC ID: 2860407194 Enrollment ID: I20190510001880 |
| Provider Name | Jennifer M Landrum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720551732 PECOS PAC ID: 8426480518 Enrollment ID: I20200903003014 |
| Provider Name | Jennifer King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780294793 PECOS PAC ID: 2668890112 Enrollment ID: I20200915001939 |
Rheumatology & Arthritis Consultants, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1980 Mesquite Ave, Suite 103, Lake Havasu City, AZ 86403 Phone: 928-680-4255 Fax: 928-680-4256 | |
Havasu Medical Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1955 Mcculloch Blvd N, Lake Havasu City, AZ 86403 Phone: 928-453-3007 Fax: 928-680-9663 | |
North Country Healthcare, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2090 N. Smoketree Ave, Lake Havasu City, AZ 86403 Phone: 928-854-1800 Fax: 928-854-1818 | |
Palo Verde Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1851 Mesquite Ave, Suite 106, Lake Havasu City, AZ 86403 Phone: 298-208-4611 Fax: 928-453-4645 | |
Frederic Luo, Md, Msee, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 Mesquite Ave, Suite 102, Lake Havasu City, AZ 86403 Phone: 480-888-1900 Fax: 480-888-1934 | |
Arizona Heart Institute Lake Havasu Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1845 Mcculloch Blvd N, Suite A6, Lake Havasu City, AZ 86403 Phone: 520-505-4442 Fax: 602-240-6177 | |
Lakeview Family Health Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2090 Smoketree Ave N, Lake Havasu City, AZ 86403 Phone: 928-854-1800 Fax: 928-854-1818 |