Organization
NES ARIZONA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BLAKEMAN (PROVIDER ENROLLMENT)
(469) 557-6183
Entity
Organization
Contact information
Practice address
5330 S HIGHWAY 95, FORT MOHAVE, AZ 86426
(928) 788-2273
Mailing address
7300 STATE HIGHWAY 121 STE 370-374, MCKINNEY, TX 75070-1987
(469) 557-6183
(469) 640-6671
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
06/05/2017
Last updated
10/25/2024
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