| Adam S. Nally, D.o., P.c. | |
|
14800 W Mountain View Blvd Suite 250 Surprise AZ 85374-4795 | |
| (623) 584-7805 | |
| (623) 584-7856 |
| Full Name | Adam S. Nally, D.o., P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 14800 W Mountain View Blvd, Surprise, Arizona |
| Authorized Official Name and Position | Adam Shane Nally (PRESIDENT/PHYSICIAN) |
| Authorized Official Contact | 6235847805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adam S. Nally, D.o., P.c. 14800 W Mountain View Blvd Suite 250 Surprise AZ 85374-4795 Ph: (623) 584-7805 | Adam S. Nally, D.o., P.c. 14800 W Mountain View Blvd Suite 250 Surprise AZ 85374-4795 Ph: (623) 584-7805 |
| NPI Number | 1811186802 |
|---|---|
| Provider Enumeration Date | 10/16/2007 |
| Last Update Date | 08/14/2020 |
| Medicare PECOS PAC ID | 2062496078 |
|---|---|
| Medicare Enrollment ID | O20040616001401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811186802 | NPI | - | NPPES |
| 704199 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3587 (Arizona) | Primary |
| Provider Name | Brittany L Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871253104 PECOS PAC ID: 7315332152 Enrollment ID: I20220315000636 |
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