Organization Active NPI

Fred S Markham MD PC

  • Internal Medicine Physician
  • Prescott, AZ
National Provider Identifier
1073545240
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FRED S MARKHAM MD PC
Practice address
804 Ainsworth Dr
Suite 104
Prescott, AZ 86301-1624
Phone
(928) 778-1736
Fax
(928) 717-0785
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Fred S Markham, MDNPI 1679538995
Title
Owner President
Phone
(928) 778-1736

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

804 Ainsworth Dr
Suite 104
Prescott, AZ 86301-1624

Mailing address

PO Box 20490
Mesa, AZ 85277-0490

National Provider Directory

National Provider Directory

Locations

804 Ainsworth Dr
Ste 104
Prescott, AZ 86301
Phone (928) 778-1736

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1073545240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20490",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852770490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 AINSWORTH DR",
            "address_2": "SUITE 104",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011624",
            "telephone_number": "928-778-1736",
            "fax_number": "928-717-0785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED S MARKHAM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "MARKHAM",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "928-778-1736",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.