| Leon A Driss Md Pc | |
|
5171 Cub Lake Rd Suite C380 Show Low AZ 85901-7888 | |
| (928) 537-1077 | |
| (928) 532-0757 |
| Full Name | Leon A Driss Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5171 Cub Lake Rd, Show Low, Arizona |
| Authorized Official Name and Position | Chris Brown (MGR) |
| Authorized Official Contact | 9285371077 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leon A Driss Md Pc 5171 Cub Lake Rd Suite C380 Show Low AZ 85901-7888 Ph: (928) 537-1077 | Leon A Driss Md Pc 5171 Cub Lake Rd Suite C380 Show Low AZ 85901-7888 Ph: (928) 537-1077 |
| NPI Number | 1770500530 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 05/05/2008 |
| Medicare PECOS PAC ID | 2860481033 |
|---|---|
| Medicare Enrollment ID | O20040511001652 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770500530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Leon A Driss |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669445706 PECOS PAC ID: 4385531516 Enrollment ID: I20051103000015 |
| Provider Name | Michele Mccormick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588199160 PECOS PAC ID: 3072882158 Enrollment ID: I20170705001856 |
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