Organization
KINGMAN GENERAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMESH C TANDON M.D. (OWNER)
(928) 681-4440
Entity
Organization
Contact information
Practice address
1739 E BEVERLY AVE, SUITE 218, KINGMAN, AZ 86409-3593
(928) 681-4440
(928) 681-4443
Mailing address
1739 E BEVERLY AVE, SUITE 218, KINGMAN, AZ 86409-3593
(928) 681-4440
(928) 681-4443
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35696
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0686409
—
NJ
Enumeration date
01/11/2007
Last updated
11/05/2007
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