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LONE WOLF MEDICINE, INC
NPI 1053504225
Physician Assistant - Medical in Payson, AZ

Active since August 21, 2007
806 S PONDEROSA ST, PAYSON, AZ 85541(928) 474-6617(928) 474-7059 Get Directions Write a Review

NPPES record last updated: August 21, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lone Wolf Medicine, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LONE WOLF MEDICINE, INC (NPI 1053504225) is a healthcare organization registered as a medical in Payson, Arizona and active in the NPI registry since August 2007. The organization lists Marilyn F Heron, Physician Assisitant, as its authorized official.

NPPES Registry Identity

NPI1053504225
Entity TypeOrganization
Primary Taxonomy363AM0700X
Legal Business NameLONE WOLF MEDICINE, INC
Location Address806 S PONDEROSA STPayson, AZ 85541-5541
Mailing AddressPo Box 1670Payson, AZ 85547-1670 · (928) 474-6617 · Fax (928) 474-7059
Phone(928) 474-6617
Fax(928) 474-7059
Organization SubpartNo
Authorized OfficialMarilyn F HeronPhysician Assisitant · (928) 474-6617
Enumeration DateAugust 21, 2007
✔ NPI 1053504225 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in AZ · 1454
806 S PONDEROSA ST, Payson, AZ 85541
Open in Google Maps ↗

Other Identifiers 4

Other2Z0986AZ · Healthnet
Medicaid137861AZ
Medicare PIN101247AZ
Medicare UPINR09370

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUDITH A HUNT M.D.
Pediatrics
806 S PONDEROSA ST
PAYSON, AZ 85541
Gila County (928) 468-8603
MR. MICHAEL KEENE DEMACK PA C S
Physician Assistant (Medical)
806 S PONDEROSA ST
PAYSON, AZ 85541
Gila County (928) 468-8603
PONDEROSA FAMILY CARE, LLC
Internal Medicine
806 S PONDEROSA ST
PAYSON, AZ 85541
Gila County (928) 468-8603
ALAN P MICHELS M.D.
Internal Medicine
806 S PONDEROSA ST
PAYSON, AZ 85541
Gila County (928) 468-8603
DURWARD LYNCH CNP
Nurse Practitioner
806 S PONDEROSA ST
PAYSON, AZ 85541
Gila County (928) 468-8603
DR. LAUREN WASHATKA MD
Internal Medicine
806 S PONDEROSA ST
PAYSON, AZ 85541
Gila County (928) 468-8603
LYNNE A VIGIL N.P.
Nurse Practitioner
806 S PONDEROSA ST
PAYSON, AZ 85541
Gila County (928) 468-8603

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lone Wolf Medicine, Inc's NPI number?

The NPI number for Lone Wolf Medicine, Inc is 1053504225. It was assigned to this organization in the NPPES registry on August 21, 2007.

Where is Lone Wolf Medicine, Inc located?

Lone Wolf Medicine, Inc is located at 806 S Ponderosa St, Payson, AZ 85541. The listed phone number is (928) 474-6617.

What is Lone Wolf Medicine, Inc's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Lone Wolf Medicine, Inc was last updated on August 21, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.