| Rocky Mountain Medical Pllc | |
|
1003 Division St Ste 1 Prescott AZ 86301-1657 | |
| (928) 777-2425 | |
| Not Available |
| Full Name | Rocky Mountain Medical Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1003 Division St, Prescott, Arizona |
| Authorized Official Name and Position | Herman Charles Heikkenen (CEO) |
| Authorized Official Contact | 9287772425 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rocky Mountain Medical Pllc Po Box 2527 Prescott AZ 86302-2527 Ph: (928) 777-2425 | Rocky Mountain Medical Pllc 1003 Division St Ste 1 Prescott AZ 86301-1657 Ph: (928) 777-2425 |
| NPI Number | 1285773549 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 11/02/2007 |
| Medicare PECOS PAC ID | 1850497884 |
|---|---|
| Medicare Enrollment ID | O20070508000100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285773549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 32037 (Arizona) | Primary |
| Provider Name | Herman C Heikkenen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437228749 PECOS PAC ID: 9335048917 Enrollment ID: I20040102000354 |
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