Douglas E Brinkerhoff, D.O.
Individual provider Active NPI Family Medicine Physician · San Carlos, AZ
NPI 1366428104 · NPPES record last updated Nov 8, 2013
Key facts
- NPI
- 1366428104
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 1428 (AZ)
- Practice address
- 223 Cibecue Circle Rd
San Carlos, AZ 85550-0208 - Phone
- (928) 475-7219
- NPI assigned
- Dec 22, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1428 | AZ | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Country Club Medical Group P C | Family Medicine | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1428 | AZ | Yes |
Addresses
Primary practice location
223 Cibecue Circle Rd
San Carlos, AZ 85550-0208
Mailing address
223 Cibecue Circle Rd
San Carlos, AZ 85550-0208
Phone (928) 475-7219
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0835990 | Other | AZ | BCBS AZ |
| 1Z7321 | Other | AZ | HEALTHNET |
Other providers in San Carlos, AZ
- Sally A Aday
- Kelly J Archambeau
- Noah Argual
- Tara Lynn Argual
- Bruce M. Bilder
- Polly Y Browning
- Melinda Rose Cain
- Wen-Te Ted Chen
- Linda C Clark
- Benjamin Joseph Cloud
All providers in San Carlos, AZ · Family Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.