| Leon a Driss PC | |
|
5300 S Sutter Dr Ste 12 Show Low AZ 85901-8055 | |
| (928) 251-2541 | |
| (833) 450-5183 |
| Full Name | Leon a Driss PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 5300 S Sutter Dr Ste 12, 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 PC Po Box 888 Lakeside AZ 85929-0888 Ph: (928) 251-2541 | Leon a Driss PC 5300 S Sutter Dr Ste 12 Show Low AZ 85901-8055 Ph: (928) 251-2541 |
| NPI Number | 1770500530 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 06/18/2024 |
| Certification Date | 06/18/2024 |
| Medicare PECOS PAC ID | 2860481033 |
|---|---|
| Medicare Enrollment ID | O20040511001652 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770500530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | 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 | Michael J Sassmann |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295049914 PECOS PAC ID: 4385660992 Enrollment ID: I20131011000001 |
| 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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