Sierra Blanca Clinic, LTD.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

10885 Issued in AZ

Legal business name

SIERRA BLANCA CLINIC, LTD.

Practice address

2963 W White Mountain Blvd
Lakeside, AZ 85929-6257

Phone

(928) 368-0765

NPI assigned

Oct 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark Mitchell Garskof, MD

Title

President

Phone

(928) 368-0765

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1801084827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859291210",
            "telephone_number": "928-368-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2963 W WHITE MOUNTAIN BLVD",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859296257",
            "telephone_number": "928-368-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA BLANCA CLINIC, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "GARSKOF",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-368-0765",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "10885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• San Tan Behavioral Health Services
• Savannah Pain Relief, LLC
• Kimberly Ann Searles, COTA/L
• Arun D Sherma, MD
• Lea Halverson Siebert, L.AC.
• Sierra Blanca Rehabilitation LLC
• Sierra Blanca Rehabilitation LLC
• Solterra at White Mountains, LLC (Solterra at White Mountains)
• Statclinix PLC (StatClinix - Lakeside)
• Step Inn LLC

• Family Medicine Physician in Lakeside, AZ
• Providers in Lakeside, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.