Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Black Canyon Community Health Center, Inc

Organization Family Medicine Physician · NPI 1679723217

Black Canyon Community Health Center, Inc provides Family Medicine Physician services in Black Canyon City, Arizona. Licensed in Arizona. Registered with an NPI since 2008.

Licensed in
AZ
In the registry since
2008
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

19251 E Oasis Dr
Black Canyon City, AZ 85324-8878
Phone: (623) 374-0200
Fax: (623) 374-5576
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 3297 (AZ)

Record details

NPI number1679723217
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Randy Hancock — Ceo · (623) 374-0200
NPI enumeratedSeptember 19, 2008
Last updated in NPPESSeptember 23, 2026
Certification dateSeptember 23, 2026
Mailing address19251 E Oasis Dr, Black Canyon City, AZ 85324-8878

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