Organization
SMITH TRYON FAMILY HEALTH INC D.B.A. BLUE WATER MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH ANNE SMITH TRYON MD (PRESIDENT)
(928) 453-6963
Entity
Organization
Contact information
Practice address
1801 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-5664
(928) 453-6963
(928) 453-7015
Mailing address
1990 MCCULLOCH BLVD N, SUITE D, BOX 379D, LAKE HAVASU CITY, AZ 86403-5749
(928) 453-6963
(928) 453-7015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35026
AZ
207R00000X
Internal Medicine Physician
35026
AZ
208D00000X
General Practice Physician
2768
AZ
Other
Enumeration date
04/20/2006
Last updated
09/27/2010
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