Organization
PINETOP MEDICAL ASSOCIATES LTD
Active
Other names
Blue Ridge Regional Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS S PAXMAN DO (OWNER)
(928) 367-6688
Entity
Organization
Contact information
Practice address
728 E WHITE MOUNTAIN BLVD, SUITE A, PINETOP, AZ 85935-7027
(928) 367-6688
(938) 367-4916
Mailing address
PO BOX 2690, PINETOP, AZ 85935-2690
(928) 367-6688
(928) 367-4916
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2577
AZ
Other
Enumeration date
03/09/2007
Last updated
05/30/2012
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