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Willow Valley Medical Center Pc

Willow Valley Medical Center Pc is a health care provider in Mohave Valley, AZ. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 8700 Highway 95, Mohave Valley, AZ 86440-8519, US
Practice Location Phone760-217-2464
Practice Location Fax928-453-9207
Legal Business NameWILLOW VALLEY MEDICAL CENTER PC
NPI ?1134111834
Entity TypeOrganization
Enumeration Date ? Aug 18, 2005
Last Update Date ? Feb 8, 2018
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Willow Valley Medical Center Pc

SpecialtySpecializationLicenseLicense State
Family Medicine 13491Arizona

legacy-id-icon Legacy Provider IDs of Willow Valley Medical Center Pc

Provider IdIssuer StateIssuer TypeIssuer
AZ0325100ArizonaOtherAZ BCBS
205288-002ArizonaMedicaid
205288-01ArizonaMedicaid
DI935ACaliforniaOtherMEDICARE PTAN
XPY055881CaliforniaMedicaid

official-icon Authorized Official of Willow Valley Medical Center Pc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Willow Valley Medical Center Pc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Donovan J Anderson (MD)
Authorized Official Title/PositionPHYSICIAN
Authorized Official Phone Number760-217-2464