Healthcare Provider Details

I. General information

NPI: 1073699112
Provider Name (Legal Business Name): AIMS PHYSICIANS AND SURGEONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 06/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 STOCKTON HILL ROAD
KINGMAN AZ
86409
US

IV. Provider business mailing address

3636 NORTH STOCKTON HILL ROAD
KINGMAN AZ
86409-0514
US

V. Phone/Fax

Practice location:
  • Phone: 928-757-3636
  • Fax: 928-757-3622
Mailing address:
  • Phone: 928-757-3636
  • Fax: 928-757-7224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AZAM S. KHAN
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 928-757-3636