Healthcare Provider Details

I. General information

NPI: 1518572668
Provider Name (Legal Business Name): ANTHONY VINCENT SALARI NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 06/30/2024
Certification Date: 06/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2735 SILVER CREEK RD
BULLHEAD CITY AZ
86442-7924
US

IV. Provider business mailing address

1320 E STERLING RD
FORT MOHAVE AZ
86426-6200
US

V. Phone/Fax

Practice location:
  • Phone: 928-763-2273
  • Fax:
Mailing address:
  • Phone: 928-246-2450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number237470
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number237470
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: