Organization
THOMAS G DALLMAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS GARY DALLMAN MD (PRESIDENT)
(928) 763-9505
Entity
Organization
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
207RI0008X
Hepatology Physician
Primary
16390
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0189940
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
11/23/2005
Last updated
08/22/2020
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