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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 704199 | Medicaid | AZ |
Other names
- Nally Family Practice
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All providers in Surprise, 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 Aug 14, 2020. 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.