1205865334

Everything you always wanted to know about MACEACHEN ANN JOAN M.D 2 MACEACHEN ANN JOAN M.D. but were afraid to ask.

MACEACHEN ANN JOAN M.D 2 MACEACHEN ANN JOAN M.D.

You can also download the this 1205865334 data report as csv | excel | json | xml
Provider Last Name Provider Middle Name Provider First Name Provider Credential Provider Other Name Type Code Provider Other Last Name Provider Other Middle Name Provider Other First Name Provider Other Credential
MACEACHEN ANN JOAN M.D 2 MACEACHEN ANN JOAN M.D.
Gender:
Female
Enumeration date:
2006-07-01
Last update date:
2008-12-16
Current as of:
2007-08-28
Is sole proprietor?:
No
Is organization subpart?:
Not Answered
In PECOS?:
Yes
Search for JOAN, MACEACHEN in
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Identifiers

identifier description issuer state active
MD5917 Medicaid none AK 1
8EC045 Medicare ID-Type Undpecified MEDICAL DOCTOR AK 1
1629236716 Medicaid none AZ 1
1871523191 Medicaid none AZ 1
1295993376 Medicaid none AZ 1
H40301 Medicare UPIN none AK 1
1780614008 Medicaid none AZ 1

Taxonomies

Taxonomy State License Number Primary?
207Q00000X Family Medicine AK 5588

Phone Numbers

Type Number
Mailing Address Telephone Number 9283384911
Practice Location Address Telephone Number 9283384911
Mailing Address Fax Number 9283383751
Practice Location Address Fax Number 9283383751

Addresses

Type Address City State Postal Country
Mailing Address 200 WEST HOSPITAL DRIVE WHITERIVER AZ 85941 AZ
Practice Location Address 200 WEST HOSPITAL DRIVE WHITERIVER AZ 85941 AZ

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