Individual
MR. CHARLES JAY BAWCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-RNP
Contact information
Practice address
1 CLINIC RD # 369, GRAND CANYON, AZ 86023-0290
(928) 638-2551
(928) 638-2598
Mailing address
PO BOX 1231, TUCSON, AZ 85702-1231
(520) 670-3909
(520) 309-2560
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
241530
AZ
Other
Enumeration date
05/26/2020
Last updated
04/21/2026
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