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CANDICE BAINEY
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1902268147
Individual Registrant: CANDICE BAINEY
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
13395 N MARANA MAIN ST MARANA, AZ 85653-7008 US
Tel: 520-682-4111 Fax: 520-682-3817
Tel: 520-682-4111 Fax: 520-682-3817
Contact information for business:
PO BOX 188 MARANA, AZ 85653-0188 US
Tel: 520-682-4111 Fax: 520-682-3817
Tel: 520-682-4111 Fax: 520-682-3817
Registration Information:
NPI: 1902268147
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | AZ | 58344 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
