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Individual

DR. THOMAS GARY DALLMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1355 RAMAR RD, SUITE 12, BULLHEAD CITY, AZ 86442-7100
(928) 763-9505
(928) 763-7370
Mailing address
1355 RAMAR RD, SUITE 12, BULLHEAD CITY, AZ 86442-7100
(928) 763-9505
(928) 763-7370

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16390
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110023320
PALMETTO R/R GBA
AZ
01
AZ0189940
BLUE CROSS BLUE SHIELD AZ
AZ
Enumeration date
11/16/2007
Last updated
08/26/2022
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