Organization
TRI-STATE NEURO-SPINE INSTITUTE, P.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ISAAC MARTIN THAPEDI M.D. (PRESIDENT)
(928) 770-4515
Entity
Organization
Contact information
Practice address
5300 S HIGHWAY 95, SUITE C, FORT MOHAVE, AZ 86426-9251
(928) 770-4515
(928) 770-4518
Mailing address
5300 S HIGHWAY 95, SUITE C, FORT MOHAVE, AZ 86426-9251
(928) 770-4515
(928) 770-4518
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
34280
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
964735
—
AZ
Enumeration date
03/10/2006
Last updated
09/09/2013
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