Michael Keene Demack
Medical Specialty
Professional ID
- NPI: 1043347313
- PECOS ID: 9739457631
- Enrollment ID: I20170619000691
- Credential(MD, DO, DPM):
- Medical School:
- Medical School Graduation Year: 1999
Hospital Service
- Hospital CCN1: 030033
- Business Name (LBN)1: Banner Payson Medical Center
Medical Practices
- Organization Name: Ponderosa Family Care, Llc
- Group Practice ID assigned by PECOS: 1456548015
- Number of Group Practice member: 3
Location
- Address1: 806 S Ponderosa St
- Address2:
- City: Payson
- State: Arizona
- Zip Code: 85541
- Phone Number: (928)468-8603
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS):
- Used Electronic health record (EHR):