Individual
THOMAS G GIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
3015 HIGHWAY 95, SUITE 105, BULLHEAD CITY, AZ 86442-4334
(928) 763-2001
(928) 763-2038
Mailing address
PO BOX 20828, BULLHEAD CITY, AZ 86439-0828
(928) 763-2001
(928) 763-2038
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3004
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
872798
—
AZ
Enumeration date
07/14/2005
Last updated
09/14/2012
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