Organization
AJMEDICUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL JOSEPH PA-C (PROVIDER, MANAGER)
(561) 573-8521
Entity
Organization
Contact information
Practice address
1467 PALMA RD STE 4, BULLHEAD CITY, AZ 86442-6785
(561) 573-8521
Mailing address
1846 E INNOVATION PARK DR STE 100, ORO VALLEY, AZ 85755-1963
(561) 573-8521
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
07/08/2024
Last updated
07/15/2024
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