Organization
TRI STATE ANESTHESIA ASSOCIATES PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERMAN V WARD MD (GROUP PRESIDENT)
(928) 763-2273
Entity
Organization
Contact information
Practice address
2735 SILVER CREEK RD, BULLHEAD CITY, AZ 86442-7924
(928) 763-2273
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100504306
—
AZ
05
—
100504306
—
NV
05
—
XGG007530
—
CA
Enumeration date
06/04/2006
Last updated
09/27/2012
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