| Organization Name: | FAMILY MEDICAL WALK IN CENTER PC |
| NPI Number: | 1982884185 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MOREEN KOPPULA (PRESIDENT / OWNER) |
| Mailing Address: | 8102 E Mcdowell Rd Suite 2a Scottsdale |
| State: | AZ US |
| Postal Code: | 852573809 |
| Phone Number: | 6022736770 |
| Fax Number: | 6028890489 |
| NPI Enumeration Date: | 11/06/2007 |
| NPI Last Update Date: | 11/06/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |