Alpine Country Urologic Associates PC

Key facts

NPI: 1598950313
Entity type: Organization (NPI type 2)
Primary specialty: Urology Physician 208800000X
License: 28174 (AZ)
Legal business name: ALPINE COUNTRY UROLOGIC ASSOCIATES PC
Practice address: 111 E Frontier St
Payson, AZ 85541-5663
Phone: (928) 468-0018
Fax: (928) 468-0019
NPI assigned: Sep 14, 2007
Organization subpart: No

Authorized official

Name: Dr. Michael A Marmer, MD NPI 1720156284
Title: President
Phone: (928) 468-0018

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

Practitioners 1

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

Michael Allan Marmer, M.D. Urology Physician · Payson, AZ · NPI 1720156284

Medicare reassignment NPD Authorized official AZ · UROLOGY

Medicare participation

Medicare fee-for-service enrollment: Enrolled in AZ

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20051008000143	AZ	Part B Supplier - Clinic/Group Practice	1557386513	Receives reassigned benefits from 1 practitioner Practice locations: Payson, AZ; Phoenix, AZ

National Provider Directory

Locations

709 W Main St
Payson, AZ 85541

709 W Main St
Ste A
Payson, AZ 85541
Phone (928) 468-0018

111 E Frontier St
Payson, AZ 85541
Phone (928) 468-0018

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Urology Physician Group: 193400000X SINGLE SPECIALTY GROUP	208800000X	28174	AZ	Yes

Addresses

Primary practice location

111 E Frontier St
Payson, AZ 85541-5663

Mailing address

PO Box 438
Payson, AZ 85547-0438
Phone (928) 468-0018

Other providers in Payson, AZ

Cami Lynn Alexander, APRN-FNP
Ali a Askari, PC
David John Allen, DMD
Allergy, Ears, Nose and Throat of Payson
Alma Medical Clinic LLC
Patricia M Alvira, CNA
Anderson Chiropractic Inc
Anderson Dental Group
Eric Jon Anderson, DDS
Rodney Dale Anderson, DC

All providers in Payson, AZ · Urology 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 Sep 14, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.