Gila Valley Medical Group LLC
Organization Active NPI Family Medicine Physician · Yuma, AZ
NPI 1992929004 · NPPES record last updated May 7, 2008
Key facts
- NPI
- 1992929004
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 20396 (AZ)
- Legal business name
- GILA VALLEY MEDICAL GROUP LLC
- Practice address
- 1951 West 25TH Street
Suite D
Yuma, AZ 85364 - Phone
- (928) 344-6263
- Fax
- (928) 785-9572
- NPI assigned
- Apr 12, 2007
- Organization subpart
- No
Authorized official
- Name
- Ronald D Brooksher, MD
- Title
- Owner
- Phone
- (928) 344-6263
Practitioners 2
National Provider Directory
Locations
1951 W 25th St
Ste D
Yuma, AZ 85364
Phone (928) 344-6263
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 20396 | AZ | Yes |
| Physician Assistant |
363A00000X | 2125 | AZ |
Addresses
Primary practice location
1951 West 25TH Street
Suite D
Yuma, AZ 85364
Mailing address
1951 West 25TH Street
Suite D
Yuma, AZ 85364
Phone (928) 344-6263
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 076275001 | Other | AACCS |
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- Cynthia Elizabeth Gill
- Shawn D Gillespie
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All providers in Yuma, 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 May 7, 2008. 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.