Organization
TRI STATE GASTROENTEROLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALTAF JAN M.D. (PRESIDENT)
(928) 763-1680
Entity
Organization
Contact information
Practice address
1225 HANCOCK RD, SUITE 205, BULLHEAD CITY, AZ 86442-5948
(928) 763-1680
(928) 763-8511
Mailing address
PO BOX 27340, PHOENIX, AZ 85061-7340
(602) 943-9200
(602) 216-3000
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
02/10/2006
Last updated
12/06/2007
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