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Contact Information

PONDEROSA PEDIATRICSS PLC
2120 CENTERPOINTE WEST DRIVE
PRESCOTT, AZ86301
 Phone: 928-443-1111
 Fax: 928-443-5554
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PONDEROSA PEDIATRICSS PLC

NPI # 1124243688
LBN Legal business name PONDEROSA PEDIATRICSS PLC
Authorized official DEANN HARGUESS - (CREDENTIALING BILLING)
Entity Organization
Organization subpart 1 No
Enumeration date 04/17/2007
Last updated 05/15/2008 - About 18 years ago
Identifiers
AZ Other 1144299090 INDIVIDUAL NPI
AZ Other 1144299678 INDIVIDUAL NPI
AZ Other 1326169657 INDIVIDUAL NPI
AZ Other 1336118926 INDIVIDUAL NPI
AZ Other 1629047097 INDIVIDUAL NPI
AZ Other 1881653558 INDIVIDUAL NPI
AZ Other 1912976879 INDIVIDUAL NPI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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