| Westside Internal Medicine Group PLLC | |
|
395 N Silverbell Rd Ste 107 Tucson AZ 85745-2718 | |
| (520) 884-0752 | |
| (520) 622-9845 |
| Full Name | Westside Internal Medicine Group PLLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 395 N Silverbell Rd Ste 107, Tucson, Arizona |
| Authorized Official Name and Position | Stanley Ofori (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5209071055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Westside Internal Medicine Group PLLC 7474 N Cobblestone Rd Tucson AZ 85718-1307 Ph: (520) 907-1055 | Westside Internal Medicine Group PLLC 395 N Silverbell Rd Ste 107 Tucson AZ 85745-2718 Ph: (520) 884-0752 |
| NPI Number | 1669775789 |
|---|---|
| Provider Enumeration Date | 12/10/2010 |
| Last Update Date | 11/06/2022 |
| Certification Date | 11/06/2022 |
| Medicare PECOS PAC ID | 2466633524 |
|---|---|
| Medicare Enrollment ID | O20110222000977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669775789 | NPI | - | NPPES |
| 957417 | Medicaid | AZ | |
| 1093793648 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Stanley Ofori |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093793648 PECOS PAC ID: 9931124021 Enrollment ID: I20051007000507 |
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