Organization
WEST FAMILY PRACTICE AND OBSTETRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD C WEST MD (OWNER)
(928) 788-9378
Entity
Organization
Contact information
Practice address
1510 E WAGON WHEEL LN, SUITE 106, FORT MOHAVE, AZ 86426-6697
(928) 788-9378
(928) 788-9381
Mailing address
PO BOX 8400, FORT MOHAVE, AZ 86427-8400
(928) 788-9378
(928) 788-9381
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
27671
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z109137
MEDICARE ID-PIN
AZ
Enumeration date
10/16/2006
Last updated
02/02/2011
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