Adam S. Nally, D.O., P.C.

Organization Active NPI Family Medicine Physician · Surprise, AZ

NPI 1811186802 · NPPES record last updated Aug 14, 2020

Key facts

NPI
1811186802
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
3587 (AZ)
Legal business name
ADAM S. NALLY, D.O., P.C.
Practice address
14800 W Mountain View Blvd
Suite 250
Surprise, AZ 85374-4795
Phone
(623) 584-7805
Fax
(623) 584-7856
NPI assigned
Oct 16, 2007
Organization subpart
No

Authorized official

Name
Dr. Adam Shane Nally, D.O.
Title
President/Physician
Phone
(623) 584-7805

National Provider Directory

Locations

14506 W Granite Valley Dr
Ste 104
Sun City West, AZ 85375
Phone (623) 640-9019

14800 W Mountain View Blvd
Ste 250
Surprise, AZ 85374
Phone (623) 584-7805

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 3587 AZ Yes

Addresses

Primary practice location

14800 W Mountain View Blvd
Suite 250
Surprise, AZ 85374-4795

Mailing address

14800 W Mountain View Blvd
Suite 250
Surprise, AZ 85374-4795
Phone (623) 584-7805

Other identifiers

IdentifierTypeStateIssuer
704199MedicaidAZ

Other names

  • Nally Family Practice Doing business as

Other providers in Surprise, AZ

All providers in Surprise, AZ · Family Medicine Physician in Arizona

Sources for this page

Verify at the official NPI Registry.