Organization
MEDICORP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAKEEL AZIZ KAHN M.D. (PRESIDENT/DIRECTOR)
(928) 768-1011
Entity
Organization
Contact information
Practice address
5225 S HIGHWAY 95, SUITE 5, FORT MOHAVE, AZ 86426-9111
(928) 768-1011
(928) 768-1075
Mailing address
5225 S HIGHWAY 95, SUITE 5, FORT MOHAVE, AZ 86426-9111
(928) 768-1011
(928) 768-1075
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
37896
AZ
207QB0002X
Obesity Medicine (Family Medicine) Physician
37896
AZ
208VP0000X
Pain Medicine Physician
Primary
37896
AZ
Other
Enumeration date
10/04/2007
Last updated
11/15/2014
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