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Organization

ARIZONA INSTITUTE OF MEDICINE AND SURGERY

Active
Other names
Outpatient Treatment Ctr
Organization subpart
No

Provider details

NPI number
Authorized official
MR. AZAM S. KHAN (CHIEF ADMINISTRATIVE OFFICER)
(928) 757-3636
Entity
Organization

Contact information

Practice address
3636 STOCKTON HILL ROAD, KINGMAN, AZ 86409
(928) 757-3680
(928) 757-3614
Mailing address
3636 STOCKTON HILL ROAD, KINGMAN, AZ 86409
(928) 757-3680
(928) 757-3614

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
OTC660
AZ
2085R0202X
Diagnostic Radiology Physician
OTC660
AZ
261QU0200X
Urgent Care Clinic/Center
Primary
291U00000X
Clinical Medical Laboratory

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
167933
AZ
Enumeration date
09/22/2005
Last updated
06/05/2018
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